Congenital epulis

Congenital epulis, also known as congenital granular cell tumour, is a benign rare tumour of the oral cavity of newborn infants. The initial first description of the lesion was dated in 1871 by Dr. Franz Ernst Christian Neumann, who coined the name for the tumour, known as Neumann's tumour. The term 'epulis' which has been used in the condition, simply refers to swelling of the gingiva, also known as gums. It may lead to mechanical obstruction and blocking of the airways, resulting in problems like respiratory distress and feeding difficulties. Such cases require immediate surgical intervention as they interfere with feeding and have the potential to cause death via lack of oxygen, and asphyxia during the perinatal and postnatal period.

Congenital epulis has an extremely low incidence of roughly 0.0006% and more than 250 cases have been described in the literature so far. The alveolar ridges of the maxilla and mandible are the most frequent sites, while occurrence on the tongue is rare. This tumour has a strong tendency for occurrence in females, which suggests hormonal involvement during embryonic development. The lesion is 3 times more frequently seen in the maxilla than in the mandible and the female: male ratio is 10:1.

The origin of congenital epulis remains unclear. Several theories have been proposed, suggesting it may arise from: (1) the same tissue that forms teeth, (2) the early structure of teeth, known as dental papilla, (3) a developmental abnormality in tooth formation, (4) a connection to a rare tumor called granular cell ameloblastoma, or (5) a similarity to another poorly understood condition called granular cell myoblastoma. A study conducted in 1970 using electron microscopy on congenital epulis and observed specialized connections between some of the granular cells. This finding hints that these cells might originate from epithelial tissue. However, their research did not provide definitive conclusions.