Background: Congenital epulis (CE) also known as congenital granuler cell tumor is a rarely encountered pathology the majority of which originates from the gingival mucosa, particularly the anterior portion of the maxillary alveolar ridge. CE mostly seen in girls. CE with unclear histogenesis and etiology is seen at birth as a solitary mass in oral cavity. Apart from non-congenital epulis, it contains granular cells. So lesion is named congenital granular cell tumor. CE has a benign histopathology and after surgery there is no recurrence reported in the literature. Aim: The purpose of this case report, is to present, 5 day-old female neonatal girl who was seen CE on the left maxillary alveolar ridge on the region of the future incisors. Case Presentation: The tumoral lesion was well-circumscribed and 10 mm in diameter, smooth surfaced and red in colour much like alveolar mucosal tissue. Tumoral lesion was affecting oral feeding due to obstruction. Excisional biopsy was performed under topical anesthesia. The histopathology was reported as congenital epulis. During the 4 months follow-up, we have seen no complication. Conclusion: CE is a neonatal congenital tumor which is very rare. The treatment of CE is surgical excision. Unless the early treatment is not executed, tumor may cause difficulties in oral feeding and respiration. Therefore it should be excised in an early period.
Congenital epulis (CE) is also known as congenital granular cell tumor; congenital gingival Neumann’s tumor and congenital myoblastoma was firstly defined by Neumann in 1871 [
A 5-day-old female neonate presented to our hospital on account of a congenital intraoral mass that was noticed by the parents at birth. On physical examination, a soft tissue tumour protruding out of newborn’s mouth was found attached to the left maxillary alveolar ridge on the region of incisors. It was well-circumscribed and 1 cm in diameter, smooth surfaced and red in colour much like alveolar mucosal tissue.The possible diagnose was congenital epulis (
CE is a benign tumor and very rarely encountered in newborns.This tumor is also known as congenital myoblastoma, gingival granular cell tumor or Neumann
tumor [
CE which in general originates from the alveolar crest of the maxilla is reported three times more frequent in the maxillary alveolus than in the mandibular alveolus [
Any recurrence or malign transformation hasn’t been reported in the literature [
CE is commonly seen in girls. Rate of incidence is reported to be 8:1 to 10:1 female-to-male ratio. An endogenous hormonal influence has been proposed to explain this gender bias, but this has not been supported by detectable estrogen and progesterone receptors within the lesion [
CE may effect muscles that close the mouth and may prevent swallowing that makes oral feeding impossible. Especially in antenatal period if size of the lesion is large, respiration may be effected and this may cause polyhydromiosis [
This tumor occurs usually as a single mass, but it has been reported that 5% - 16% of cases may be as multiple. When the tumor occurs as multiple, maxilla or mandible are the most frequent locations [
In one case congenital goiter with CE and in another case midfacial hypoplasia with CE were reported. In our case, the patient had no other congenital anomaly, no medical history, not even the occasional midfacial hypoplasia and anomalies of the nasal complex that is sometimes seen in some cases due to pressure effect from the lesion on the developing maxilla [
The lesion was attached by means of a thin pedicle to the alveolar ridge. This is in consonance with most cases that are pedunculated [
The diagnosis of CE should essentially be clinical in fact, prenatal imaging of congenital epulis is possible by ultrasound and MRI, but unfortunately this oral tumour has rarely been diagnosed prenatally [
In conclusion, CE is a neonatal congenital tumor which is very rare. The treatment of CE is surgical excision. Unless the early treatment is not executed, tumor may cause difficulties in oral feeding and respiration. Therefore it should be excised in an early period.
Pekçetin, Z.S., Senemtaşı, A., Koçak, G.E., Kumral, S., Yaltirik, M. and Koray, M. (2018) Congenital Epulis of the Newborn: A Case Report. Open Journal of Stomatology, 8, 120-126. https://doi.org/10.4236/ojst.2018.84011