Oral cavity & oropharynx

Soft tissue tumors & proliferations

Congenital epulis of newborn



Last author update: 1 January 2013
Last staff update: 19 January 2024

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PubMed Search: Epulis oral cavity

Charu Thakral, M.D.
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Cite this page: Thakral C. Congenital epulis of newborn. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/oralcavityepulis.html. Accessed March 28th, 2024.
Definition / general
  • Congenital granular cell tumor of alveolar mucosa of jaw in newborns
  • 90% girls; 10% present as multiple lesions
  • Doesn't recur, even if incompletely excised
  • 0.5 - 2 cm soft, pedunculated mucosal mass
  • Spontaneously regresses over first 8 months of life (Am J Surg Pathol 1981;5:37)
Terminology
  • Congenital granular cell myoblastoma, granular cell epulis of infancy and granular cell fibroblastoma
Sites
  • Exclusively on anterior alveolar ridge of maxilla and mandible, usually overlying future canine and lateral incisor teeth
Case reports
Clinical images

Contributed by Dhiraj B. Nikumbh, M.B.B.S., M.D.

2 day old girl with
difficulty eating and
breathing due to
upper jaw lesion



Images hosted on other servers:

Lesion at 3 weeks

Lesion at 16 months

Tumor arising from anterior maxillary alveolus

Gross images

Contributed by Dhiraj B. Nikumbh, M.B.B.S., M.D.

Congenital granular cell tumor

Microscopic (histologic) description
  • Confluent to nodular submucosal growth of tumors composed of large polygonal cells with eosinophilic granular cytoplasm and small central nuclei
  • Overlying epithelium is atrophic; does NOT show pseudoepitheliomatous hyperplasia (common with granular cell tumor of adults)
Microscopic (histologic) images

Contributed by Dhiraj B. Nikumbh, M.B.B.S., M.D. and Kelly Magliocca, D.D.S., M.P.H. (Case #524)

Stratified squamous epithelium

Abundant granular eosinophilic cytoplasm

S100


Scanning magnification

Scanning magnification

Stroma and overlying surface epithelium

Stroma and overlying surface epithelium

Sheet-like growth

Sheet-like growth

Granular stromal cells

Granular stromal cells



Images hosted on other servers:

Polygonal cells

Positive stains
Negative stains
  • S100 (in contrast to granular cell tumor of adults), laminin, Leu7, NSE
Differential diagnosis
Board review style question #1
Which of the following is a feature of congenital granular cell epulis?

  1. Clinical presentation at ages 5 - 15
  2. Detection within first trimester
  3. Female predilection
  4. Local recurrence after excision
  5. Pseudoepitheliomatous hyperplasia
Board review style answer #1
C. Female predilection. The characteristic presentation of CGCE is the presence of a solitary, soft pedunculated mass on the anterior maxillary alveolar ridge in a female infant. The female to male ratio is striking at nearly 8:1. Pseudoepitheliomatous hyperplasia is not present (the overlying epithelium is attenuated) and recurrence has not been reported (J Neonatal Surg 2015;4:17).

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