Congenital epulis of the newborn; A case report.

INTRODUCTION: Congenital epulis, also known as Neumann's tumor, is an uncommon benign tumor of the oral mucosa that occurs in newborns. It is a rare condition, with fewer than 250 reported cases worldwide. The exact cause or underlying mechanism of this tumor is still not well understood. CASE PRESENTATION: We present a three-day-old male neonate who presented with a swelling on the gingiva that had been present since birth. The infant did not encounter any difficulties with feeding or breathing. The patient had a single, round, pink swelling measuring 2 × 2 × 1 cm on the right maxillary alveolar ridge. The swelling was surgically removed under general anesthesia. Microscopic examination revealed large polygonal cells with abundant granular cytoplasm, centrally located nuclei indicating a diagnosis of congenital epulis. CLINICAL DISCUSSION: Clinical manifestation could vary from no symptoms to feeding difficulty and rarely airway obstruction. It usually tends to grow on anterior alveolar ridge of the newborns, more on the maxilla than on the mandible. Confirmation of the diagnosis is by histopathology, which commonly shows proliferation of polygonal round cells with eosinophilic granular cytoplasm and round central nucleus. Congenital epulis can be approached using different management techniques depending on the size, site of the tumor, and presenting symptoms of the newborns. CONCLUSION: Congenital epulis is rare, but it has to be considered as a differential diagnosis for gingival swelling among neonates.

Congenital epulis of the newborn: 2 cases report and a literature review / 口腔疾病防治

Objective@#To investigate the clinical features, diagnosis and treatment of congenital epulis, to provide a reference for clinical diagnosis and treatment.@*Methods@#Two cases of congenital epulis in the mandible and maxilla of a newborn were reported, and the boundary and size of the tumor were determined by ultrasonography and MRI. The tumor was resected under general anesthesia. The previous literature on congenital epulis was reviewed and analyzed.@*Results@#Patient 1 (male) had a hard mass of approximately 20 mm × 15 mm × 10 mm in the right mandible immediately after birth. MRI was performed, and the mass was removed. In Patient 2 (female), a mass approximately 24 mm × 23 mm × 20 mm in the oral cavity of the anterior maxillary region was shown on ultrasound at 29 gestational weeks, and the mass grew rapidly in the last trimester. The mass was removed after birth. Postoperative pathological examination revealed congenital epulis. The results of the literature review showed that the incidence of congenital epulis is greater in females than in males, and it mainly occurs in the maxillary incisor area. Congenital epulis does not invade bone and does not affect tooth development. When a mass affects a child's breathing or swallowing, it must be surgically removed in a timely manner. Recent studies have shown that there is no evidence of recurrence after surgical resection. The histological origin and etiology of the disease are not clear. Clinically, it is often necessary to distinguish between teratomas and congenital epulis. Regarding the clinical manifestations, teratomas and congenital epulis are similar in appearance, and the main distinguishing point lies in pathological manifestations. Under the microscope, teratomas are observed as mature or immature tissue from various embryonic layers, while congenital epulis involves tightly arranged, homogeneous, polygonal to microspindle-shaped, medium to large cell compositions of nest-like and ribbon-like cells.@*Conclusion@#Congenital epulis is a rare oral tumor in neonates. The diagnosis should be based on the location, age, clinical manifestations, and imaging findings. The final diagnosis depends on pathological examination. When congenital epulis tumors affect children's breathing and eating, they should be surgically removed as soon as possible, and there is almost no recurrence after surgery.

Congenital epulis: a rare diagnosis of newborn.

Congenital epulis is a rare benign soft tissue lesion that occurs exclusively in neonates and usually develops from the alveolar mucosa at the frontal region of the maxilla. Lesions may be sessile or pedunculated, normal in color or reddish and vary in size from a few millimeters to a few centimeters. Although spontaneous regression has also been reported, surgical excision is indicated for large tumors that may obstruct the airway and make feeding the child difficult. In this case report, we present a rare case of congenital epulis involving the right side of the maxillary alveolar mucosa in a neonate delivered vaginally at Dhulikhel Hospital, Kavreplanchok, Nepal. The lesion was surgically removed by electrocautery, and histologic examination confirmed the clinical diagnosis of congenital epulis. No complications occurred after surgery, and when the child was examined 6 months later, no evidence of recurrence noticed.

Anesthetic management of congenital epulis in a newborn: a case report.

The epulis of the newborn is a granular cell tumor that originates from the mucosa of the gingiva. Case presentation: The authors report a case of a 4-day-old neonate with a large mass arising from the right upper gingival area and occupying most of the oral cavity who presented for surgery with a potentially difficult airway. Intubation was achieved uneventfully using a gaseous induction with an appropriate-size facemask and displacement of the epulis to allow cautious laryngoscopy. Discussion: General anesthesia offers good airway protection and also alleviates the stress and pain associated with the surgery. Conclusion: Congenital epulis is a relatively rare congenital tumor of a newborn, which is one of the causes of difficult airways in neonates and children. However, after slight manipulation of the tumor, endotracheal intubation for the administration of general anesthesia is attainable.

Congenital Epulis Diagnosed Antenatally.

Background: Congenital epulis is a benign gingival tumor whose differential diagnosis includes other oral-facial masses such as teratoma, hemangioma, lymphatic malformation and dermoid cysts. This tumor can cause obstruction of the airway or feeding problems in the newborn. Surgical excision is the treatment of choice. Case Report: We present a case of congenital epulis, diagnosed prenatally with ultrasonography. Conclusion: Although difficult, a defined prenatal image of congenital epulis is possible by means of accurate high-resolution ultrasonography. It facilitates the narrowing down of differential diagnosis. The confirmatory final diagnosis relies on histopathological examination.

Congenital epulis in a newborn.

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.

Congenital Epulis of the Newborn: A Report on Two Cases.

Granular cell epulis is a rare benign tumor of the newborn. It originates from the alveolar ridge, most commonly from the maxillary alveolar ridge. Despite its striking appearance, the lesion is ultimately benign. However, immediate surgical treatment is required if there is a risk of airway obstruction or feeding difficulties. We report two cases of granular cell epulis presented at birth, the first with a large mass originating from the maxillary alveolar ridge and the second with the mass originating from the mandibular alveolar ridge. Both were successfully managed with surgical excision without complications. Histopathology of both masses confirmed the granular cell epulis diagnosis.

Clinical and histopathological features of congenital epulis in a newborn submitted to laser surgery.

Congenital epulis (CE) is a rare condition in newborns, whose histogenesis remains unclear. It mostly presents as a circumscribed mass in the maxilla alveolar ridge of female neonates and can interfere with their normal breathing and breastfeeding. This benign oral lesion usually appears as a pedunculated nodule covered with normal mucosa that extends from the anterior vestibular alveolar ridge up to the posterior region. There are some pathological conditions that show clinical and histopathological features similar to those of CE, such as granular cell tumor, gingival cyst of the newborn, vascular malformations and others. This case report aimed to describe the clinical and pathological features of a newborn patient with a clinical and histopathological diagnosis of CE on the right side of the maxillary alveolar ridge, treated with excision by laser surgery, with a follow-up of 5 months without any sign of recurrence.

Congenital epulis of the newborn: a case report.

The objective of this case report is to describe a congenital epulis of the newborn. A 10-day-old female neonate was brought to a dental clinic for examination of an intraoral lesion that was present at birth. No systemic changes were noted during the extraoral examination. During the intraoral examination, a nodular exophytic lesion was found in the maxillary left alveolar ridge. The appearance suggested a congenital epulis. The nodular, pedunculated lesion had a diameter of 13 mm, firm consistency, smooth surface, and color varying from pink to red. Newborns with such lesions usually have difficulty breastfeeding and may experience respiratory difficulties. The patient underwent an excisional biopsy under local infiltrative anesthesia with 2% lidocaine. Histopathologic examination of the lesion confirmed the diagnosis of congenital epulis. There were no postoperative complications. At the follow-up examination 8 days after the biopsy, her weight and length had already increased, and the oral mucosa had a normal appearance. At 8 months of age, she demonstrated continued gains in weight and length. Dentists must familiarize themselves with abnormalities that may affect the oral cavity of neonates as well as the differential diagnoses and treatment options.

Congenital granular cell epulis of newborn: importance of prenatal diagnosis.

Congenital granular cell epulis is a rare benign lesion usually arising as single mass from the alveolar ridge of maxillary bone of female newborns, composed of polygonal granular cells that typically stain negative for S-100, in contrast to the adult counterpart. Larger lesions can disturb breathing and breast-feeding, requiring surgery. Prenatal diagnosis is achieved in few cases, even if this would be important for best management of delivery and therapy. Here we present a case of multiple CGCE in a female newborn discovered at birth, together with a brief review of pathogenesis, differential diagnoses and treatment implications of early diagnosis.

Congenital Epulis of the Newborn: A Case Report and Literature Review.

Congenital epulis is a rare benign lesion of new-born and occurs mostly as a single tumor. A new-born infant with congenital epulis is a striking sight for both parents and health care professionals involved in neonatal care. The tumor has a female predilection with the female to male ratio being 10:1. These tumors in the infant's mouth are remarkably large, occupying much of the oral cavity and posing a risk of airway obstruction and it can interfere with the feeding. Although the clinical presentation of the congenital tumor is rather distressing, owing to its size and aggressive appearance, it is very much necessary that the attending pediatricians, pediatric surgeon be cognizant of the nature of this rare yet benign congenital tumor. The purpose of this article is to present a case report documenting the clinical presentation and management of Congenital Epulis on the anterior maxillary alveolus in a three-day old female patient. HOW TO CITE THIS ARTICLE: Babu E, Kamalasanan G, Prathima GS, et al. Congenital Epulis of the Newborn A Case Report and Literature Review. Int J Clin Pediatr Dent 2021;14(6):833-837.

Congenital Epulis: A Case and Review of the Literature.

Congenital epulis is an unusual benign oral mucosal lesion in newborns with no tendency to recur after excision. The histogenesis of the lesion is unknown, but it is believed to be of mesenchymal origin. We describe a case of congenital epulis (20×10 mm) in the mandibular gingiva of a newborn. The mass, which was smooth-surfaced and pedunculated with a healthy color, was surgically removed at 5 months post-birth. Histologically, the tumor consisted mainly of large eosinophilic granular cells. Immunohistochemical studies revealed intense staining for vimentin, STRO-1, and CD44, suggesting that it was derived from mesenchymal cells. The literature and immunohistochemical profile of congenital epulis are also discussed.

Neumann's Tumor: A Case Report.

BACKGROUND: The congenital granular cell tumour of the newborn, also known as congenital epulis or Neumann's tumor, is rare. It occurs on the gingiva of the anterior alveolar ridge of the jaws. This lesion behaves in a benign manner and no recurrent or metastatic lesions have been reported. CASE REPORT: We are reporting a 2-day-old female neonate, who came to our unit with a well defined, solitary, firm mass arising from the maxillary anterior region measuring about 3.5 cms in diameter and causing difficulty in breast feeding but no hindrance to the airway. The mass was surgically excised under general anesthesia. Postoperative wound healing was uneventful. CONCLUSION: We have shared our experience in handling this rare type of tumor. We have presented the clinical features and the different modalities of its treatment to spread awareness among clinicians for better management of similar tumors.

Congenital Gingival Granular Cell Tumor: A Case Report.

The congenital gingival granular cell tumor (CGCT), also as known as congenital epulis, is an unusual benign oral mucosal lesion in newborns. A two-day-old female patient was admitted to the Department of Pediatric Dentistry at Gulhane Medical Academy, Ankara, Turkey with her family, and an intraoral examination showed a CGCT located in the buccal region of the maxillary right first primary molar. In this report, we present a case of CGCT in a newborn.

Congenital epulis: A rare benign tumour

Congenital epulis is a rare benign pedunculated tumour of the oral cavity arising from the alveolar ridges. It is usually detected in newborns and can be successfully resected surgically. We report a case of a newborn baby who had a 5x3x3cm pedunculated lobar mass arising from the upper alveolar ridge.

Congenital granular cell tumor - a rare entity.

Congenital granular cell tumor is a rare benign neoplastic growth affecting the gingival mucosa of neonates. Prenatal ultrasound diagnosis has recently come to focus and in spite of several reports on immune-histochemical and other advanced marker studies, the cause and origin of the lesion remains debatable till date. Review of literature on prenatal diagnosis and histopathology along with immunohistochemistry is discussed.

Histogenesis and clinical analysis of 2 cases of congenital gingival granular cell tumour.

Dentistry for babies aims to contribute to the formation of a generation with fewer dental problems, higher quality of oral health and more aware of the importance of prevention. The congenital gingival granular cell tumour (CGCT) is a rare benign soft tissue tumour in the newborn that can lead to respiratory difficulties and feeding. The aim of this work was to report two cases of CGCT in babies and discuss the clinical and histological differential diagnosis and their treatment, as well as the importance of knowledge of this pathology for dentists. Clinical features and treatment approaches are presented and discussed. The surgical approach improved the child quality of life and restored the parent's confidence and emotional stability. Knowledge of this pathology helps in better diagnosis and treatment, which lead to a better quality of life of children and return confidence and emotional stability to parents.

Congenital epulis of the newborn.

Congenital epulis, a benign tumor of the oral cavity, is an extremely rare condition in newborn. It may lead to mechanical obstruction, therefore resulting in respiratory distress and difficulty in feeding. Addressing the problem may need a multidisciplinary team approach at the time of birth. Antenatal ultrasonography and perinatal magnetic resonance imaging are an adjunct to treatment planning. Prenatal diagnosis remains difficult as the findings are nonspecific due to the late development of the tumor. Surgical excision is, therefore, the treatment of choice. Our report discusses this condition and the treatment thereafter on a newborn, with an epulis originating from the upper alveolar ridge discovered at birth. Histological examination confirmed the diagnosis of large polygonal granular cells. The mass was excised under general anesthesia, and the outcome was good after surgery allowing regular feeds on the second postoperative day.

Congenital epulis: immunohistochemical findings of 12 cases

Congenital epulis is a fairly rare soft tissue tumour occurring exclusively on the alveolar ridge of newborns. The exact origin of congenital epulis is still debatable. The objective of the study is to determine the clinicopathological features and immunohistochemical findings of congenital epulis. A retrospective study was carried out to determine the clinicopathological features of congenital epulis, diagnosed histologically in the main oral histopathology laboratory in Malaysia from 1967 to 2014. Immunostaining using vimentin, muscle specific actin, smooth muscle antigen, desmin, S100, CD34, CD68 and CD1a was carried out. Twelve cases of congenital epulis were reviewed. All of the patients were females and the presentation age ranged from 2 to 90 days. The patients comprised of 6 Malays, 3 Chinese, 2 Indians and 1 Orang Asli. Most of the cases (n=7) involved the maxillary ridge and presented as pedunculated well-defined lumps (n=8). Excisional biopsy was performed in all cases. Via immunohistochemistry, vimentin expression was observed in all cases; but negative for CD34, muscle specific actin, smooth muscle antigen, and desmin. CD1a and S100 positivity was seen in five cases. The interstitial cells were highlighted by CD68. Although congenital epulis has been first described 130 years ago, the exact nature of its histogenesis remains a mystery.

Épulis congénito del recién nacido, una sorpresa para el Neonatólogo / Congenital epulis of the newborn, a surprise to the neonatologist

RESUMEN El épulis congénito del recién nacido es un tumor benigno, pediculado, de consistencia firme y tamaño variable, poco frecuente, de presentación bucal que tiene predilección por el sexo femenino. Se localiza habitualmente en la zona anterior y superior del maxilar superior. En caso de ser de gran tamaño puede interferir en la alimentación y dificultar la alimentación del neonato. La resección quirúrgica es el mejor tratamiento. El presente trabajo expone un caso y hace una revisión de la literatura.

ABSTRACT The congenital epulis of the newborn is a benign tumor, pedunculated, with a hard consistency and variable size rare, oral and of presentation that has a predilection for females. It is usually located in the anterior and superior maxilla. In case of big size it can interfere with feeding and can cause difficult neonatal feeding. Surgical resection is the best treatment. In this paper we presents a case and a review of the literature.