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We report a 69-year-old female on Apixaban who presented with sudden, profuse oropharyngeal bleeding. Examination revealed a friable, sessile erythematous mass on the right soft palate that was actively bleeding. The lesion was surgically excised with electrocautery under local anesthesia after appropriate management of anticoagulation. Histopathology confirmed lobular capillary hemangioma (PG). No recurrence was observed at follow-up. This case highlights the importance of prompt recognition and complete excision of PG in anticoagulated patients, as even small lesions may precipitate life threating hemorrhage.<\/jats:p>","DOI":"10.1093\/jscr\/rjag044","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:51:11Z","timestamp":1769086271000},"source":"Crossref","is-referenced-by-count":1,"title":["Atypical soft palate pyogenic granuloma in an elderly anticoagulated patient presenting with acute oropharyngeal hemorrhage"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8490-3149","authenticated-orcid":false,"given":"Ammir","family":"Abuzahra","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Faculty of Medicine, Hebron University , Hebron P7060796 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