J Korean Assoc Oral Maxillofac Surg.  2022 Dec;48(6):382-385. 10.5125/jkaoms.2022.48.6.382.

Congenital epulis in a newborn

• Kang MJ
• Kang SH

• KMID: 2537564
• DOI: http://doi.org/10.5125/jkaoms.2022.48.6.382

Abstract

Congenital epulis (CE) is an extremely rare benign tumor of the gingiva that is found on the alveolar ridge of newborns, and the main treatment option is simple excision. Postoperative prognosis is very good, and spontaneous regression may occur despite incomplete excision. This report presented a rare case of CE and its healing process after surgery under local anesthesia. The treatment plan was decided upon through consultation between a medical team and the patient’s family, with surgical excision for the main lesion, which benefitted from surgery, and follow-up for a very small-sized lesion, which was thought to be appropriate for a newborn. No recurrence was found after its removal, and favorable healing was observed.

Keyword

Congenital epulis; Congenital epulis

Figure

• 

  Fig. 1 Initial clinical photography. A 1-cm×1-cm-sized, smooth-surfaced pedunculated mass on the right mandibular alveolar ridge and postero-lingually; about 2-mm-sized small mass also in the sublingual region.

• 

  Fig. 2 The lesion being excised with an electric cautery device during surgery.

• 

  Fig. 3 The microscopic features of histopathological examination revealed granular tumor cells with abundant cytoplasm upon H&E staining (×100).

• 

  Fig. 4 Immunohistochemical properties of lesion cells were negative for S-100 protein. Sustentacular cells that support tumor structure were observed in the basal layer between the tumor cell nests (×100).

• 

  Fig. 5 Clinical photography taken five months after surgery. Mandibular ridge showed good healing without a defect, and its width and height were normal.

• 

  Fig. 6 Clinical photography taken one year after surgery. Mandibular ridge showed good healing.

Reference

References

1. Childers EL, Fanburg-Smith JC. 2011; Congenital epulis of the newborn: 10 new cases of a rare oral tumor. Ann Diagn Pathol. 15:157–61. https://doi.org/10.1016/j.anndiagpath.2010.10.003. DOI: 10.1016/j.anndiagpath.2010.10.003. PMID: 21393037.

2. Bosanquet D, Roblin G. 2009; Congenital epulis: a case report and estimation of incidence. Int J Otolaryngol. 2009:508780. https://doi.org/10.1155/2009/508780. DOI: 10.1155/2009/508780. PMID: 20130770. PMCID: PMC2809329.

3. Klingler PJ, Seelig MH, DeVault KR, Wetscher GJ, Floch NR, Branton SA, et al. 1998; Ingested foreign bodies within the appendix: a 100-year review of the literature. Dig Dis. 16:308–14. https://doi.org/10.1159/000016880. DOI: 10.1159/000016880. PMID: 9892790.

4. Yuwanati M, Mhaske S, Mhaske A. 2015; Congenital granular cell tumor - a rare entity. J Neonatal Surg. 4:17. DOI: 10.47338/jns.v4.170. PMID: 26034711. PMCID: PMC4447470.

5. Vered M, Dobriyan A, Buchner A. 2009; Congenital granular cell epulis presents an immunohistochemical profile that distinguishes it from the granular cell tumor of the adult. Virchows Arch. 454:303–10. https://doi.org/10.1007/s00428-009-0733-y. DOI: 10.1007/s00428-009-0733-y. PMID: 19205730.

6. Wittebole A, Bayet B, Veyckemans F, Gosseye S, Vanwijck R. 2003; Congenital epulis of the newborn. Acta Chir Belg. 103:235–7. https://doi.org/10.1080/00015458.2003.11679415. DOI: 10.1080/00015458.2003.11679415. PMID: 12768872.

7. Roy S, Sinsky A, Williams B, Desilets V, Patenaude YG. 2003; Congenital epulis: prenatal imaging with MRI and ultrasound. Pediatr Radiol. 33:800–3. https://doi.org/10.1007/s00247-003-1024-4. DOI: 10.1007/s00247-003-1024-4. PMID: 12961042.

8. Stewart CM, Watson RE, Eversole LR, Fischlschweiger W, Leider AS. 1988; Oral granular cell tumors: a clinicopathologic and immunocytochemical study. Oral Surg Oral Med Oral Pathol. 65:427–35. https://doi.org/10.1016/0030-4220(88)90357-x. DOI: 10.1016/0030-4220(88)90357-X. PMID: 2834681.

9. Lack EE, Perez-Atayde AR, McGill TJ, Vawter GF. 1982; Gingival granular cell tumor of the newborn (congenital "epulis"): ultrastructural observations relating to histogenesis. Hum Pathol. 13:686–9. https://doi.org/10.1016/s0046-8177(82)80018-x. DOI: 10.1016/S0046-8177(82)80018-X. PMID: 6282735.

10. Bertozzi M, Nardi N, Falcone F, Prestipino M, Appignani A. 2010; An unusual case of asymptomatic appendicular cutting foreign body. Pediatr Med Chir. 32:223–5. PMID: 21171522.

11. Elkousy H, Harrelson J, Dodd L, Martinez S, Scully S. 2000; Granular cell tumors of the extremities. Clin Orthop Relat Res. 380:191–8. https://doi.org/10.1097/00003086-200011000-00026. DOI: 10.1097/00003086-200011000-00026. PMID: 11064991.

12. Sakai VT, Oliveira TM, Silva TC, Moretti AB, Santos CF, Machado MA. 2007; Complete spontaneous regression of congenital epulis in a baby by 8 months of age. Int J Paediatr Dent. 17:309–12. https://doi.org/10.1111/j.1365-263X.2006.00795.x. DOI: 10.1111/j.1365-263X.2006.00795.x. PMID: 17559460.

13. López de Lacalle JM, Aguirre I, Irizabal JC, Nogues A. 2001; Congenital epulis: prenatal diagnosis by ultrasound. Pediatr Radiol. 31:453–4. https://doi.org/10.1007/s002470000416. DOI: 10.1007/s002470000416. PMID: 11436896.

14. Fister P, Volavsek M, Novosel Sever M, Jazbec J. 2007; A newborn baby with a tumor protruding from the mouth. Diagnosis: congenital gingival granular cell tumor. Acta Dermatovenerol Alp Pannonica Adriat. 16:128–30. PMID: 17994174.