Addressing the problem may need a multidisciplinary team approach at the time of birth. Congenital epulis, histologically a granular cell tumor, is a rare neonatal tumor. The typical presentation is a solitary nodule occurring on the gingiva of the anterior alveolar ridge of either jaw. We report the prenatal sonographic and postnatal mr imaging findings in an infant. It is essential to document the presentation and the management of this lesion because of its rare nature. The objective of the study is to determine the clinicopathological features and immunohistochemical findings of congenital epulis. The full text of this article is available in pdf format. Congenital epulis american journal of clinical pathology.
A rare case of congenital epulis of the newborn with multiple. Natal teeth may be probed as a causative factor of congenital fibrous epulis. This mass can mean many different things to different people. It usually occurs as a single mass, however, multiple epulis have also been reported. Granules in granular cell lesions of the head and neck. Epulis means swelling on the gingiva, and currently, the accepted terminology for epulis in the literature is a congenital epulis of newborn. In this article we present a case report of an otherwise healthy female neonate with two congenital. Ce with unclear histogenesis and etiology is seen at birth as a solitary mass in oral cavity. Multiple congenital granular cell epulis in a female. It may lead to mechanical obstruction, therefore resulting in respiratory distress and difficulty in feeding. It is seen as a mass arising in the mouth from the alveolar ridge.
The clinical appearance, histological features and method of treatment are described. Congenital epulis clinically appears as a pedunculated protuberant mass. In congenital epulis, vimentin, which is a marker for intermediate filament in cells of mesenchymal origin is 100% positive and s100 protein, which is a marker for neural cell origin is 100% negative. Multiple congenital epulis in alveolar ridges of maxilla and. The origin of congenital epulis has not yet been completely elucidated, and the many hypotheses with. Can j plast surg vol 15 no 4 winter 2007 215 treatment of congenital epulis granular cell tumour with excision and gingivoperiosteoplasty kailash narasimhan md1, jugpal s arneja md frcsc2, rajah rabah md3. Once diagnosed the traditional management of the lesion has been surgical excision under general anesthesia. We report a case in a female newborn infant of multiple congenital epulis, i.
This tumour can cause obstruction of the airway or feeding problems in the newborn child. Epidemiology it occurs almost exclusively in females when it presents in the fetal. It predominately affects females, mainly on the anterior maxillary alveolar ridge, and occurs usually as a single mass, although sometimes as multiple. This lesion is more commonly found in female babies, suggesting hormonal involvement during embryonic development. It has the potential to interfere with feeding and cause airway. Congenital epulis is a proliferation of cells most frequently occurring on the alveolar ridge of the upper jaw at birth. Congenital granular cell epulis exclusively occurs in newborn infants, predominately girls femalemale, 910. In our clinic we found seven cases of congenital fibrous epulis and all the cases had one or two natal teeth in the tumors. Congenital epulis threedimensional ultrasonographic findings and clinical implications lawrence shaw, md, ahmed almalt, md, s.
She had six round, soft, multiple, pedunculated swelling masses, of which two were on her upper anterior ridge and four on her lower anterior ridge. Carlan, md, donald plumley, md, lennard greenbaum, md, james kosko, md congenital gingival granular cell tumor is a rare benign intraoral tumor found only in the neonate and is commonly known as congenital epulis. Congenital epulis is also referred to as congenital granular cell myoblastoma, granular cell epulis of infancy, and granular cell fibroblastoma. Can j plast surg vol 15 no 4 winter 2007 215 treatment of congenital epulis granular cell tumour with excision and gingivoperiosteoplasty kailash narasimhan md1, jugpal s arneja md frcsc2, rajah rabah md3 1department of otolaryngology, wayne state university. The differential diagnosis for an infant with the congenital epulis would include congenital malformations, such as encephalocoele, dermoid cysts, teratomas as well as benign and malignant tumours. Congenital melanocarcinoma, melanotic adamantinoma, retinal.
Article pdf available in brazilian dental journal 231. Congenital epulis of the newborn kumar r m, bavle rm. Introduction congenital epulis ce, also known as congenital granular cell tumor cgct, is a rare benign tumor of newborns that was first described by neumann et al. Congenital granular cell tumor cgct, or congenital epulis, is an uncommon benign soft tissue lesion that usually arises from the alveolar mucosa of neonates and may cause respiratory and feeding problems. It is a localized, pedunculated, spongy mass with a smooth surface. Here we report an unusual case of congenital granular cell epulis present in the mouth of a 4dayold asian chinese female newborn. The exact origin of congenital epulis is still debatable.
The remnants act as inciting agents to precipitate an inflammatory reaction. Remarkable similarities are noted between this lesion and the adult granular cell tumor myoblastoma by both light and electron microscopy. Congenital granular cell epulis is an uncommon tumor which is apparent at birth. 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. The cause and origin of congenital epulis remains unclear. The congenital epulis gingival granular cell tumor is a rare lesion of unknown origin found only in newborn infants. Congenital granular cell lesion cgcl or congenital epulis is an uncommon benign of the oral cavity tumor appearing at birth with typical clinical and pathologic features. Epulis inflammatoire, a cellules geantes, fibreuse, gravidique, congenitale. The lesion is more common in female neonates and normally affects the maxillary alveolar ridge. The mass arose with a narrow stem from the mandibular alveolar ridge. Prenatal diagnosis and perinatal management pankaj kumar md division of neonatalperinatal medicine, schneider childrens hospital, long island jewish medical center, the university hospital and long island campus for the albert. Pdf granules in granular cell lesions of the head and. In this article we present a case report of an otherwise healthy female neonate with two congenital epuli. Pregnancy epulis, pregnancy tumor, pyogenic granuloma pregnancy epulis.
Polygonal cells with granular cytoplasm and small round nuclei. Congenital epulis or congenital gingival granular cell tumor refers to an exophytic congenital tumor that arises from the alveolar ridge and has histologic features identical to those of granular cell tumor fig. Congenital fibrous epulis, natal teeth, infant, oral surgery introduction congenital fibrous epulis is a very rare benign gingival tumor in infants and was first described by majid et al in 1986 1. Congenital epulis is a rare benign intraoral tumor, which mostly occurs along the gingiva of the alveolar ridges of the newborn.
An epulis granulomatosa is a granuloma which grows from an extraction socket the hole left after a tooth has been removed, and as such can be considered to be a complication of healing after oral surgery. Introduction congenitalepulis,alsoknownascongenitalgranu lar cell tumour cgct, granular cell fibroblastoma, congenital granular cell myoblastoma, or neumanns. Congenital epulis of the newborn this benign submucosal lesion presents at birth, predominantly in females, and is frequently located in the maxillary anterior area. Congenital epulis, or granular cell tumour, is a rare, benign intraoral tumour present on the mucosa of the alveolar ridge, with the potential to interfere with respiration and feeding. Congenital epulis usually occurs as a single mass although 10% of the cases occur as multiple masses. Congenital granular cell myoblastoma radiology reference. Microscopically, it demonstrates nests of polygonal cells with granular. Epulis granulomatosa is a benign tumorlike proliferation arising from a poorly healing extraction socket, a complication as a result of bony spicules or tooth fragments within the socket. Also known as neumanns tumor newman, 1871, it has varyingly been referred to as congenital gingival granular cell tumor cgct of the. Neumann first described congenital epulis of a newborn in 1871, hence it is also known as neumanns tumor. Congenital epulis definition of congenital epulis by.
The congenital granular cell tumour of the newborn, also known as congenital epulis, is rare. Congenital epulis of the newborn, also known as congenital granular cell tumor, is a rare gingival neoplasm that affects the alveolar ridge in the newly born 28. Macroscopically, the external surface was slightly irregular and the cut surface was homogenous and tan fig 3. Congenital epulis, also known as neumanns tumour, is a rare congenital growth affecting the gingival mucosa of neonates. Congenital epulis is usually a single lesion, but in 10% of cases it may be multiple, as in our case 2,3,5. Keywords epulis granulomatosa, extraction socket, granulation tissue correspondence dr. This large group of disorders affects almost 5 percent of infants and includes several major groups of conditions. First described by neumann in the 19th century7, it has only been noted in newborns and is a different entity from other granular cell tumors. Congenital epulis is an unusual benign oral mucosal lesion in newborns with no tendency to recur after excision. Congenital epulis, also known as congenital granular cell tumor, is a rare benign intraoral tumor which occurs along the gingiva of alveolar ridges of the jaws.
There has also been a case report of co 2 laser use with general anesthesia. The size of the epulis varies from a few mm to 9 cm. Less frequently the mass may arise from the mandibular alveolus. Case report congenital fibrous epulis associated with. This condition may interfere with respiration, feeding or lip closure. Congenital epulis was first described by neumann in 1871 and as a result. It occurs on the gingiva of the anterior alveolar ridge of the jaws. What are the management options for congenital epulis. The aim of this paper is to study the combine application in the. It occurs usually as a single mass with various sizes, although some multiple lesions have also.
Introduction in the oral cavity, the gingiva is the most. Ling summary an unusual case offibrous epulis in a newborn is presented. Case report congenital fibrous epulis associated with natal teeth. Confluent to nodular submucosal growth of tumors composed of large polygonal cells with eosinophilic granular cytoplasm and small central nuclei. The histogenesis of the lesion is unknown, but it is believed to be of mesenchymal origin. Congenital epulis of the newborn is a rare gingival tumor that occurs along the alveolar ridge. An external file that holds a picture, illustration. The past literature showed that there was no other abnormality around or in the tumors in their mouths. Jan 06, 2016 introduction congenital granular cell epulis ce is a rare benign tumor occurring exclusively in neonates.
D congenital epulis, american journal of clinical pathology, volume 22, issue 11, 1 november 1952, pages 10441053, h we use cookies to enhance your experience on our website. Congenital epulis ce is a rare benign tumour in neonates. Learning points congenital epulis is a rare intraoral tumour in oral cavity of newborns. Epulis, or congenital granular cell tumor gct, is a rare tumor of the newborn. It arises from the alveolar mucosa and occurs more frequently in the maxilla, mainly in the frontal region. Two clinical cases of congenital epulis were used to illustrate the presentation and surgical management of the lesion. Congenital epulis is a rare lesion of the newborn, presenting as mass in the oral cavity which can interfere with respiration and feeding. Congenital granular cell epulis is a rare and benign lesion in newborn. Congenital epulis, also known as granular cell tumour of the gingiva, congenital granular cell myoblastoma, or newmanns tumour, following the first published case,16 is encountered exclusively in newborns. Other terminologies for cgct described in literature are congenital epulis, granular.
In our case there were multiple congenital epulides originating from both the mandible and maxilla. Abstract congenital epulis is a fairly rare soft tissue tumour occurring exclusively on the alveolar ridge of newborns. Congenital epulis of the newborn pubmed central pmc. Congenital epulis has never been reported to undergo malignant transformation or to continue growth after birth. Treatment of congenital epulis granular cell tumour with. Multiple congenital epulis of the mandibular ridge. These slow growing soft tissue tumors affect the gingivae of a new born child. Surgical excision is the only possible treatment, although spontaneous regression has been reported. Epulis tumors in the mouths of dogs pet health network. Perez, md congenital granular cell epulis is a rarely reported lesion of unknown histogenesis with a strong predilection for the maxillary alveolar ridge of newborn girls. Congenital epulis occurs at birth and has a predilection for females. Case report multiple congenital epulis in alveolar ridges of maxilla and mandible in a newborn.
Histologically congenital epulis does show the presence of large cells with eosinophilic granular cytoplasm. Our case was a female infant, in whom the lesion occurred in the anterior mandibular gum pad. The congenital epulis is an oral mass that presents at birth in neonates. We report the prenatal sonographic and postnatal mr imaging findings in an infant with maxillary and mandibular congenital epulides. Pregnancy epulis is a pyogenic granuloma of the gingiva, which develops rarely during pregnancy in women. Treatment involves surgical excision, and recurrences are rare. The lesion has a site predilection for the anterior maxillary alveolar process and a 9. Confluent to nodular submucosal growth of tumors composed of large polygonal cells with. A congenital granular cell myoblastoma also known as congenital epulis is a very rare benign tumor which classically presents in the fetalneonatal population. The congenital gingival granular cell tumor cgct, also as known as congenital epulis, is an unusual benign oral mucosal lesion in. Congenital epulis presentation a baby girl was referred to our hospital immediately after birth, for a mass protruding from her mouth. Congenital epulis is a rare lesion found on the alveolar process of a newborn child, diagnosed soon after birth. About europe pmc funders joining europe pmc governance. Diagnosis and management of oral lesions and conditions in the.
Congenital fibrous epulis is a very rare benign gingival tumor in infants. Although there have been around 200 reports of its postnatal diagnosis, this oral tumor has rarely been diagnosed prenatally. The clinical hypothesis of congenital granular cell epulis cgce was. Congenital epulis, a benign tumor of the oral cavity, is an extremely rare condition in newborn. Infant 1 presented at birth with a large bilobulated tumorous mass figure 1a. Lymphangiomas are rare congenital lymphatic malformations. The first clinical case is a one month old female child with a protruding gum tumour on the anterior alveolar process of the mandible. A case report kannan s karthiga 1, rajesh r 2 1 dept.
Congenital epulis differs from other granular cell tumours encountered in adults by its exclusive origin from the neonatal gingiva, the scattered presence of odontogenic epithelium, the more elaborate vasculature and the lack of interstitial cells with angulate bodies. Congenital epulis classification and external resources diseasesdb 32726 the congenital epulis is a proliferation of cells on the upper jaw at birth. We present a case of congenital epulis, diagnosed prenatally with us. Pathology outlines congenital granular cell epulis. However, there are rare cases reported on the tongue and the lesions may be multiple in about 10%. We report two termborn female neonates with dissimilar presentations of ce despite normal antenatal scans. Congenital epulis is a benign gingival tumour whose differential diagnosis includes other oralfacial masses such as haemangioma, granular cell myoblastoma and cystic hygroma. Congenital granular cell tumor, also known as congenital epulis, is a very rare lesion seen in newborns. These findings were consistent with congenital granular cell tumour of the newborn. By continuing to use our website, you are agreeing to our use of cookies. Congenital epulis ce of the newborn is a rare benign soft tissue tumor that presents at birth. It has a female predilection with a female and male ratio of 8.
A newborn infant with multiple congenital oral swellings can be a striking sight for both parents and healthcare professionals involved in neonatal care. Epulis tumors and dogs one of the most common types of oral masses is called an epulis pronounced ehpewliss. It occurs usually as a single, exophytic and pedunculated nodule, with a smooth or lobulated surface, located on the alveolar ridge of newborns. Congenital epulis has classically been managed by complete surgical excision under general or local anesthesia. However, below the surface of the mass, something much more threatening may be lurking.
It is also known as congenital gingival granular cell tumor. Pdf treatment of epulis fissuratum with carbon dioxide laser in. Epulis is seen only in the newborn and is a different entity from other granular cell tumors. Congenital epulis of the newborn introduction tumors of the oral cavity are not common among newborns 1. Case report multiple congenital epulis in alveolar ridges of. It occurs usually as a single mass with various sizes, although some multiple lesions have also been reported. Histologically, it was composed of diffuse sheets and. Prenatal ultrasound detection of a congenital epulis in a triple x female fetus. Congenital epulis is a lesion with benign behavior, which affects the oral cavity of newborns.
The term epulis derives from the greek word meaning on the gingiva. Congenital epulis is an uncommon benign tumor that originates from the alveolar ridge in newborns. Multiple congenital epulis of the alveolar ridge and. The greek word epulis means swelling of the gingiva. Malformations are abnormalities of the human form that arise.
Congenital epulis of newborn is an extremely rare gingival tumor that occurs typically on the alveolar ridge of the jaw. Multiple congenital epulis in newborn a rare presentation. Congenital epulis why does congenital epulis occur. Congenital epulis ce is a rare tumor of the newborn, also known as granular cell tumor or congenital gingival granular cell tumor because of its histologic features. The congenital epulis of the newborn is a rare oral benign lesion, of unclear histogenesis and that appears exclusively in newborns. Congenital epulis of the newborn is a rare benign softtissue tumour of the gingival, which is also called gingival granular cell tumour of the newborn. Epulis is a general term used to describe a number of reactive gingival lesions with vascular, fibroblastic, and granulation tissue proliferation. The lesion likely develops late in utero as it is often not detected on antenatal ultrasound. Congenital disorder, abnormality of structure and, consequently, function of the human body arising during development. Congenital epulis is a rare, softtissue benign condition that presents at birth.
A rare case report jaya naidu, shreya banerjee, sapna jyoti, pavanalakshmi gp, kirthana satish abstract introduction. What is thought to be the cause of congenital epulis and why. Congenital granular cell epulis archives of pathology. The mass prevented normal closure of the mouth, was hindering normal breast or bottlefeeding, but did. Pdf epulis fissuratum is a pseudotumor growth located over the soft tissues of. Unusualetiologyofairway obstructionandfeedingfailureinanewborn shilpavishwanath,md,ms 1. It is benign condition, seen more frequently in females, with multiple epuli occurring in only 10% of cases. It is not clear why congenital epulis occur but they are thought to originate from primitive mesenchymal cells of neural crest origin. We present fetal mri and doppler prenatal imaging of an infant with two congenital epulides simultaneous. Congenital epulis, also known as granular cell tumour of the gingiva, congenital granular cell myoblastoma, or newmann.
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