Congenital Epulis

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JEANNETTE NJI, MD, SOMIL GUPTA, MD, and SUMIT FOGLA, MD
Doctors’ Hospital of Michigan Family
Medicine Program, Pontiac

During a newborn check, a 3-day-old girl was noted to have a 1-cm firm, noncompressible, mucosal swelling on the anterior mandibular ridge (A). The newborn was solely breastfed with no feeding problems. The mother reported no complaints. Remaining examination findings were normal.

The infant has a congenital epulis, a rare benign oral tumor first described by Neumann in 1871.¹ Also known as Neumann tumor or gingival granular cell tumor, congenital epulis has a female preponderance of 8:1. The differential diagnosis includes various types of inclusion cysts, such as Epstein pearl, Bohn nodule, dental lamina cyst, mucocele, and ranula.

Congenital epulis typically occurs as a single mass arising from the gingival mucosa of the maxillary or, less commonly, the mandibular alveolar ridge. Up to 10% of the tumors occur as multiple lesions. The tumor may range in size from several millimeters to 9 cm.^2,3 Large protuberant lesions may interfere with respiration or feeding and require surgical excision.

Clinical identification is key to management. Congenital epulis usually is asymptomatic and spontaneously resolves within the first 3 to 6 months of life.⁴ Recurrence after spontaneous regression or surgical resection is rare. The lesion rarely interferes with future dentition.⁴

This newborn had complete resolution by age 6 months, and a tooth had erupted at the site of the lesion (B).

REFERENCES:

1. Neumann E. Ein fall von congenitaler epulis. Archiv der Heilkunde. 1871;12:189-190.

2. Lapid O, Shaco-Levy R, Krieger Y, Kachko L, Sagi A. Congenital epulis. Pediatrics. 2001;107(2):E22.

3. Ruschel HC, Beilke LP, Beilke RP, Kramer PF. Congenital epulis of newborn: report of a spontaneous regression case. J Clin Pediatr Dent. 2008;33(2):167-169.

4. Eghbalian F, Monsef A. Congenital epulis in the newborn, review of the literature and a case report. J Pediatr Hematol Oncol. 2009;31(3):198-199.