Journal of Postgraduate Medicine
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Year : 1993  |  Volume : 39  |  Issue : 1  |  Page : 36  

Congenital epulis.

R Subramaniam, R Shah, V Kapur 
 Dept of Paediatric Surgery, Bai Jerbai Wadia Hospital for Children, Parel, Bombay, Maharashtra.

Correspondence Address:
R Subramaniam
Dept of Paediatric Surgery, Bai Jerbai Wadia Hospital for Children, Parel, Bombay, Maharashtra.

Abstract

A tumor was found to be arising from the right maxillary alveolar margin of a newborn baby. No other congenital abnormality was detected. Following excision and histopathological examination, diagnosis of benign congenital granular cell epulis was made. The post-operative course was uneventful.



How to cite this article:
Subramaniam R, Shah R, Kapur V. Congenital epulis. J Postgrad Med 1993;39:36-36


How to cite this URL:
Subramaniam R, Shah R, Kapur V. Congenital epulis. J Postgrad Med [serial online] 1993 [cited 2020 Apr 10 ];39:36-36
Available from: http://www.jpgmonline.com/text.asp?1993/39/1/36/652


Full Text




  ::   IntroductionTop


Congenital epulis is a rare tumour of newborn infant predominantly in girls and is essentially benign. A case history of congenital epulis of the newborn is described. We have also tried to review literature on the same.


  ::   Case reportTop


A baby girl weighing 2.8 kg born by normal vertex delivery after an uneventful forty weeks pregnancy was noted to have a large mass arising from the right maxillary alveolar margin. [Figure:1]

There was no family history of congenital abnormality. Examination findings revealed 5x7x6 cms irregular mass, soft to firm in consistency arising from the maxillary alveolus. Palate and lip were normal. Presence of tumour interfered directly with feeding. There was no evidence of respiratory difficulty. Tumour was excised and the material sent for histopathology. Post- operative recovery was uneventful.

Histopathology showed sheets and nests of large spheroidal and fusiform granular cells showing no aberrant features in a fibrous stroma; covered by squamous epithelium without keratinisation consistent with diagnosis of benign congenital granular cell epulides (GCE).


  ::   DiscussionTop


Congenital epulis is strikingly common in females (8F:1M) as also in our case. Maxilla is affected approximately twice as often as the mandible[1].

Five major theories have been put forth to explain the origin and pathology involved i.e. myoblastic, neurogenic, odontogenic, fibrobiastic and histiocytic. However, controversy remains unresolved[2].

Differential diagnosis is granular cell tumor and is made on the basis of (a) female sex preponderance, (b) anterior maxillary location, (c) presence at birth, (d) lack of a pseudoepitheliomatous hyperplasia of overlying squamous epithelium in the latter disorder, and (e) S-100 protein is present in granular cell tumour (GCT) but absent in GCE.

Therefore GCE and GCT have different cells of 2 origin. GCE has most probably a mesenchymal origin.

Another theory is that it is produced due to an intra-uterine stimulus from fetal ovaries, thus explaining the increased female preponderance. It is also known to regress spontaneously[3]. However, limited excision is the treatment of choice. The prognosis is excellent with very rare recurrence[3].

References

1 Rainey JB, Smith IJ. Congenital epulis of the newborn. J Pediatr Surg 1984; 19:305-306
2Lifshitz MS, Flotte TJ, Greco MA. Congenital granular cell epulis. Cancer 1984; 53:1845-1848.
3Cussen LJ, MacMohan RA. Congenital granular cell myobiastoma J Pediatr Surg 1975; 10:249-253.

 
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