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Lobular capillary hemangioma (LCH), also known as pyogenic granuloma, is a benign capillary proliferation with a microscopically distinctive lobular architecture that affects the skin and mucous membrane of the oral cavity and nasal region. LCH commonly involves the nasal cavity as a small hypervascular lesion arising from the anterior third of the septum or the lateral wall. Its diagnosis may be difficult in those rare instances of a large LCH that entirely fills the nasal cavity,which can be confused with more aggressive neoplasms such as hemangiopericytoma or angiosarcoma. We report an intriguing case of LCH associated with epidural hematoma presenting as a huge expansile lesion involving the anterior skull base and orbit. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:448-51