Spontaneous regression of congenital epulis: a case report and review of the literature

Abstract

IntroductionCongenital epulis is a rare lesion found on the alveolar process of a newborn child, diagnosed soon after birth. The lesion has a site predilection for the anterior maxillary alveolar process and a 9:1 sex predilection for females. Once diagnosed the traditional management of the lesion has been surgical excision under general anesthesia.Case presentationThe purpose of this case report is to describe spontaneous regression of congenital epulis in a three week old healthy African American female child. She presented with a 1.5 cm bilobed sessile nodular lesion in the region of the right maxillary cuspid. The clinical impression was congenital epulis. Since the lesion was not interfering with feeding and respiration, a conservative approach was taken. The child was followed-up for 18 months, during which the lesion progressively regressed.ConclusionsConservative management prevented unnecessary surgery and anesthesia exposure in a neonate.

Congenital Epulis: a clinical case presentation

“…– 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 …”

“…Approximately 200 cases have been reported in the literature 1 – 3 , 9 ; with only 9 cases diagnosed prenatally 1 …”

“…CE most often presents as a single intraoral soft tissue mass of variable size, 1 , 9 , 13 usually arising from the maxillary alveolar ridge 1 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 …”

“…, 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 …”

“…Spontaneous regression has been reported, 9 , 12 , 13 but surgical excision is the most common treatment. CE has not been reported to reoccur 2 , 4 , 5 nor has malignant epulis ever been reported 2 …”