Multiple congenital epulis in newborn - A rare presentation

Abstract

A newborn infant with multiple congenital oral swellings can be a striking sight for both parents and healthcare professionals involved in neonatal care. Neumann first described congenital epulis of a newborn in 1871, hence it is also known as Neumann's tumor. Congenital epulis occurs at birth and has a predilection for females. Congenital epulis clinically appears as a pedunculated protuberant mass. In cases with large lesions, mechanical, oral, and nasal obstruction can impair fetal deglutition or interfering with feeding and / or respiratory impairment. We are reporting a case of a six-day-old, 3.5 kg newborn female, who had reported to our institution with multiple congenital oral swellings arising from the maxilla and mandible.

Congenital Epulis: a clinical case presentation

“…, 12 , 13 CE is now thought to be a reactive or degenerative lesion with a mesenchymal origin 2 4 CE has never been observed to increase in volume after birth, 2 or show malignant conversion 2 , 4 – 8 or recur after excision 7 11 , 13 CE is not generally associated with any other congenital abnormality 1 …”

“…Differential diagnosis can include: Oropharyngeal teratomas 1 , 8 , 9 Haemangioma 1 , 3 – 9 , 13 Anterior encephalocele 1 , 5 , 8 Cystic lymphangioma 4 , 8 , 12 Digestive or tongue duplications 1 , 3 Fibroma 9 , 12 , 13 Rhabdomyoma and rhabdomyosarcoma 9 , 12 , 13 Schwannoma 3 , 13 …”

“…– 13 It was first described by Neumann in 1871 1 – 4 , 6 , 9 and as such it is also called Neumann's tumour or a congenital gingival granular cell tumour 5 9 , 12 , 13 , 14 …”

“…, 8 – 13 However, it has also been reported arising from the tongue and mandible 2 – 4 , 6 – 9 , 12 , 13 and as multiple lesions in 10% of cases 2 4 , 7 Its size is variable, ranging from a few millimeters to 9cm 1 3 It is more common in females, predilection rate reported at 8:1–10:1 6 …”

“…CE has not been reported to reoccur 2 , 4 , 5 nor has malignant epulis ever been reported 2 4 – 8 According to Nyberg, et al 11 fetal facial tumours are not generally associated with any chromosomal abnormalities, although CE has been diagnosed in a female XXX fetus.…”