Congenital Granular Cell Lesion: Clinical, Microscopic and Immunohistochemical Aspects in a Case of Multiple Lesions

Abstract

Congenital granular cell lesion of the newborn, also known as congenital epulis, is a rare benign oral cavity tumor presenting at birth. Usually, it appears as a solitary mass arising in the mouth and originates from the anterior alveolar ridge. The objective of the present article is to report a case of congenital granular cell lesion in an 8-day-old female newborn. The patient presented four intraoral pedunculated lesions. Diagnosis, treatment, microscopic and immunohistochemical characteristics are also discussed.

Multiple Congenital Granular Cell Epulis: Case Report and Immunohistochemical Profile with Emphasis on Vascularization

“…The lack of immunoreactivity with S-100 suggests that CGCE is derived from a different cell line to GCT. It also highlights the absence of Schwann cells in CGCE, which corroborates the findings of other studies [ 2 , 4 – 7 , 12 ]. Other studies have, however, reported positivity for neuron-specific enolase (NSE), suggesting that a neural origin should not be ruled out [ 10 ].…”

“…This case report describes multiple CGCE of the maxilla and mandible, present at birth in a female newborn, which corroborates the clinical features described by other authors. Although the diagnosis of CGCE is usually clinical, due to its characteristic occurrence on the alveolar ridge in neonates, a differential diagnosis, which includes teratoma, hemangioma, lymphatic malformation, congenital malformation, or neoplasm, should also be considered [ 2 , 5 , 7 ].…”

“…Its growth ceases postpartum, where spontaneous regression has been observed [ 21 , 22 ]. Conservative surgical excision is usually the treatment of choice [ 3 , 4 , 7 , 14 ], and recurrence has not been reported. Conservative treatment followed by close clinical follow-up has been described for lesions which do not interfere with feeding and breathing [ 20 ].…”

“…The prognosis of CGCE is good, owing to its benign behavior and growth, and the absence of recurrence following excision, even when incompletely removed. Malignant transformation has not been reported [ 7 ]. In the current report, clinical follow-up at one month revealed alveolar ridges with a normal appearance, with no signs of recurrence.…”

Congenital epulis: Report of two cases

“…Immunologically, CE is positive for vimentin and neuron specific enolase. [6,7] It is believed that it develops reactively in response to maternal hormones during pregnancy. Tendency to decrease in size or even spontaneous resolution after birth as maternal hormones reduce, supports this theory.…”