Oral cavity & oropharynx
Soft tissue tumors & proliferations
Congenital epulis of newborn
Author: Charu Thakral, M.D.
Last author update: 1 January 2013
Last staff update: 19 January 2024
Copyright: 2002-2024, PathologyOutlines.com, Inc.
PubMed Search: Epulis oral cavity
Table of Contents
Definition / general | Terminology | Sites | Case reports | Clinical images | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosis | Board review style question #1 | Board review style answer #1Cite this page: Thakral C. Congenital epulis of newborn. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/oralcavityepulis.html. Accessed December 26th, 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
- Newborn girl with 2 cm tumor (Pediatrics 2001;107:E22)
- 2 day old girl with 4 x 2 cm exophytic growth (Pan Afr Med J 2012;12:105)
- 3 week old girl with spontaneous regression (J Med Case Rep 2010;4:331)
- 3 week old girl had a pedunculated lesion of the anterior maxillary alveolar process, which was excised (Case of the Month #524)
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
Stroma and overlying surface epithelium
Sheet-like growth
Granular stromal cells
Images hosted on other servers:
Polygonal cells
Positive stains
Differential diagnosis
- Granular cell tumor:
- Adults, infiltrates deep tissues, overlying epithelial hyperplasia
- S100+
- Verruciform xanthoma:
- Adults, overlying papillomatosis
Board review style question #1
Which of the following is a feature of congenital granular cell epulis?
- Clinical presentation at ages 5 - 15
- Detection within first trimester
- Female predilection
- Local recurrence after excision
- 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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