Congenital epulis of the jaw: a series of five cases and review of literature

Abstract

This article describes five cases of congenital epulis, a rare and benign swelling in the mouth of a newborn, which is not widely known. We present five cases: four cases presented as single pedunculated nodules of the gingiva and in one case two nodules were present. Of all, 50% were located at the maxilla. Excision was performed in four of the five cases and in one case, spontaneous regression was awaited. No recurrence was reported. The characteristic features of congenital epulis are a pedunculated, flesh-pink coloured tumour with a predominant occurrence on the anterior maxillary alveolar ridge in a female newborn. Although the aetiology is unknown, most authors suggest a mesenchymal, rather than an odontogenic, origin. Endogenous hormonal factors might influence growth prenatally. Histological findings include granular cells with eosinophilic cytoplasm and small, eccentric nuclei. Despite the fact that the lesion can be a striking sight, spontaneous regression is possible and can be awaited. Indications for non-radical excision under local anaesthesia are severe upper airway obstruction and interference with feeding technique. In conclusion, we provide clinical and histological information about congenital epulis, so that this entity will be more easily recognised and relevant information given to parents.

Congenital epulis (congenital gingival granular cell tumor)

“…The various proposed cells of origin are of the odontogenic epithelium, undifferentiated mesenchymal cells, pericytes, fibroblasts, smooth muscle cells, nerve related cells, and histiocytes (10) . However, most authors suggest a mesenchymal origin (11) .…”

Multiple giant cell granuloma – a case report

“…ulega samoistnej resorpcji w czasie jednego-czterech miesięcy po porodzie, a jedynie 25 proc. wymaga leczenia chirurgicznego [8,9], a także nadziąślaki wrodzone, opisane po raz pierwszy w 1871 r. przez Neumana, a obecnie prezentowane jako kazuistyka [10,11,12].…”

Neonatal airway obstruction caused by rapidly growing nasopharyngeal teratoma

“…Epignathus has to be differentiated from congenital epulis, a solid granular cell tumour in the mouth (3), which has been previously described by Küpers et al. (4). We present a case report of a rapidly growing epignathus in a preterm infant with severe upper airway obstruction.…”