Congenital epulis is a rare benign congenital mass of the neonatal alveolar ridge or gingiva. It is typically recognized at birth, can sometimes be detected prenatally, and larger lesions can interfere with feeding or the airway. It shows a marked female predilection, commonly summarized in the literature as an approximately 8-10:1 female-to-male ratio. Histology shows a granular-cell lesion with a non-neural, mesenchymal or hamartomatous immunophenotypic profile in contemporary pathology reports. Prognosis after complete excision is excellent, with recurrence reported as rare in the retrieved case literature.
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name: Congenital Epulis
creation_date: "2026-05-09T13:24:47Z"
updated_date: "2026-05-09T22:35:21Z"
description: >
Congenital epulis is a rare benign congenital mass of the neonatal alveolar
ridge or gingiva. It is typically recognized at birth, can sometimes be
detected prenatally, and larger lesions can interfere with feeding or the
airway. It shows a marked female predilection, commonly summarized in the
literature as an approximately 8-10:1 female-to-male ratio. Histology shows a
granular-cell lesion with a non-neural, mesenchymal or hamartomatous
immunophenotypic profile in contemporary pathology reports. Prognosis after
complete excision is excellent, with recurrence reported as rare in the
retrieved case literature.
category: Congenital Oral Soft Tissue Neoplasm
disease_term:
preferred_term: congenital epulis
term:
id: MONDO:0015528
label: congenital epulis
parents:
- Epulis
- Granular cell tumor
- Soft tissue neoplasm
- Hamartoma
- Gingival neoplasm
synonyms:
- Congenital granular cell epulis
- Congenital granular cell tumor
- Congenital gingival granular cell tumor
- Congenital myoblastoma
- Neumann tumor
progression:
- phase: Post-excision outcome
notes: >
After complete local excision, published case literature describes excellent
short-term prognosis and no recurrence at early follow-up.
evidence:
- reference: PMID:40860794
reference_title: "Congenital granular cell epulis in a neonate: a case report and review of diagnosis, treatment, and prognosis."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "The prognosis is excellent following complete excision."
explanation: >
This review/case report directly supports excellent prognosis after
complete excision.
- reference: PMID:42051968
reference_title: "Congenital Granular Cell Epulis in a Newborn: Diagnostic and Surgical Challenges in a Resource-Limited Setting-A Case Report."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Postoperative recovery was uneventful, with complete resolution and no recurrence at the one-month follow-up."
explanation: >
This case report supports uncomplicated early recovery and no early
recurrence after excision.
pathophysiology:
- name: Congenital Gingival Granular Cell Proliferation
description: >
Congenital epulis is a localized benign congenital lesion of gingival or
alveolar-ridge soft tissue. Current pathology literature favors a
non-neural, likely mesenchymal or hamartomatous origin, although the exact
histogenesis remains uncertain. A hypothesized intrauterine hormonal
influence has been proposed to explain the strong female predilection and
postnatal growth arrest, but it remains unproven. Local granular-cell
proliferation forms the exophytic neonatal oral mass and can mechanically
impair feeding or, rarely, respiration.
cell_types:
- preferred_term: mesenchymal cell
term:
id: CL:0008019
label: mesenchymal cell
biological_processes:
- preferred_term: cell population proliferation
term:
id: GO:0008283
label: cell population proliferation
modifier: ABNORMAL
locations:
- preferred_term: gingiva
term:
id: UBERON:0001828
label: gingiva
- preferred_term: alveolar ridge
term:
id: UBERON:0004103
label: alveolar ridge
evidence:
- reference: PMID:15533573
reference_title: Obstructive congenital gingival granular cell tumour.
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Congenital gingival granular cell tumours (CGCT) are rare and always benign intraoral tumours originating from the alveolar ridge."
explanation: >
This case-based review directly supports congenital epulis as a benign
intraoral granular-cell lesion arising from the alveolar ridge.
- reference: PMID:41925794
reference_title: "Cytoplasmic Granules in Granular Cell Tumor and Congenital Epulis: A Histochemical and Immunohistochemical Note."
supports: PARTIAL
evidence_source: HUMAN_CLINICAL
snippet: "CE, however, lacks S-100 expression and demonstrates absent or weak CD68 staining, favoring a non-neural, likely mesenchymal or hamartomatous origin."
explanation: >
This histochemical and immunohistochemical analysis supports a
non-neural mesenchymal or hamartomatous interpretation, while still
leaving histogenesis incompletely resolved.
downstream:
- target: Gingival mass
description: >
Localized gingival or alveolar-ridge proliferation produces the clinically
apparent oral mass.
causal_link_type: DIRECT
evidence:
- reference: PMID:42051968
reference_title: "Congenital Granular Cell Epulis in a Newborn: Diagnostic and Surgical Challenges in a Resource-Limited Setting-A Case Report."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "It presents most commonly as a pedunculated mass arising from the maxillary alveolar ridge and may interfere with feeding or, rarely, respiration."
explanation: >
The abstract directly links the alveolar-ridge lesion to the observed
pedunculated oral mass and its mechanical consequences.
- target: Feeding difficulty
description: >
Larger oral masses can block latch or oral intake, causing neonatal
feeding difficulty.
causal_link_type: DIRECT
evidence:
- reference: PMID:32779496
reference_title: "Large Congenital Epulis: A Neonatal Tumour with Striking Appearance, but Simple Management."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Mouth closing and normal feeding were hampered."
explanation: >
This large congenital epulis case directly supports the edge from oral
mass effect to impaired feeding.
- target: Respiratory compromise risk
description: >
Very large lesions can threaten airway patency, although not all cases
produce respiratory distress.
causal_link_type: DIRECT
evidence:
- reference: PMID:32779496
reference_title: "Large Congenital Epulis: A Neonatal Tumour with Striking Appearance, but Simple Management."
supports: PARTIAL
evidence_source: HUMAN_CLINICAL
snippet: "Larger lesions interfere with mouth closing and normal feeding and may obstruct airways."
explanation: >
This supports airway obstruction as a potential mechanical consequence
of large lesions, so the edge is marked partial rather than universal.
phenotypes:
- category: Oral
name: Gingival mass
description: >
A congenital gingival or alveolar-ridge oral mass is the defining clinical
presentation, often pedunculated and protruding into the oral cavity.
phenotype_term:
preferred_term: gingival mass
term:
id: HP:0000168
label: Abnormality of the gingiva
evidence:
- reference: PMID:15533573
reference_title: Obstructive congenital gingival granular cell tumour.
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "They are typically seen as a mass protruding out of a newborn child's mouth."
explanation: >
This supports the visible neonatal oral mass as the characteristic
presentation.
- reference: PMID:28579714
reference_title: "Neumann's Tumor: A Case Report."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "It occurs on the gingiva of the anterior alveolar ridge of the jaws."
explanation: >
This supports localization of the mass to gingiva/anterior alveolar
ridge.
- category: Oral
name: Feeding difficulty
description: >
Large oral lesions may interfere with mouth closure, latch, or normal
neonatal feeding.
phenotype_term:
preferred_term: Feeding difficulties in infancy
term:
id: HP:0008872
label: Feeding difficulties in infancy
evidence:
- reference: PMID:32779496
reference_title: "Large Congenital Epulis: A Neonatal Tumour with Striking Appearance, but Simple Management."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Mouth closing and normal feeding were hampered."
explanation: >
This large congenital epulis case directly documents impaired normal
feeding.
- reference: PMID:40860794
reference_title: "Congenital granular cell epulis in a neonate: a case report and review of diagnosis, treatment, and prognosis."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "a smooth, multilobulated mass on the right maxillary alveolar ridge causing feeding difficulties."
explanation: >
This case report directly links the alveolar-ridge mass to feeding
difficulty.
- category: Respiratory
name: Respiratory compromise risk
description: >
Large congenital epulis lesions can threaten airway patency, but airway
compromise is conditional on lesion size and position rather than an
obligate manifestation.
phenotype_term:
preferred_term: Respiratory distress
term:
id: HP:0002098
label: Respiratory distress
evidence:
- reference: PMID:32779496
reference_title: "Large Congenital Epulis: A Neonatal Tumour with Striking Appearance, but Simple Management."
supports: PARTIAL
evidence_source: HUMAN_CLINICAL
snippet: "Larger lesions interfere with mouth closing and normal feeding and may obstruct airways."
explanation: >
The abstract supports potential airway obstruction in large lesions, but
it does not imply respiratory distress in every infant with congenital
epulis.
- reference: PMID:12439158
reference_title: "Obstructive congenital epulis: prenatal diagnosis and perinatal management."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "concerns regarding the patency of the airway at birth necessitated development of a multidisciplinary team"
explanation: >
These obstructive prenatal cases support airway compromise risk and the
need for delivery-room airway planning.
histopathology:
- name: Granular eosinophilic tumor cells
description: >
Histopathology shows large polygonal cells with granular eosinophilic
cytoplasm, fitting the granular-cell lesion pattern that defines congenital
epulis.
finding_term:
preferred_term: granular eosinophilic tumor cells
term:
id: HP:0025461
label: Abnormal cell morphology
diagnostic: true
evidence:
- reference: PMID:42051968
reference_title: "Congenital Granular Cell Epulis in a Newborn: Diagnostic and Surgical Challenges in a Resource-Limited Setting-A Case Report."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Histopathology revealed large polygonal cells with granular eosinophilic cytoplasm and atrophic overlying epithelium"
explanation: >
This exact microscopic description supports the granular eosinophilic
cell morphology used to confirm congenital epulis.
- name: Atrophic overlying epithelium
description: >
Atrophy of the epithelium overlying the granular-cell lesion can be present
histologically, supporting distinction from adult granular cell tumor
patterns that may show pseudoepitheliomatous hyperplasia.
diagnostic: true
evidence:
- reference: PMID:42051968
reference_title: "Congenital Granular Cell Epulis in a Newborn: Diagnostic and Surgical Challenges in a Resource-Limited Setting-A Case Report."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Histopathology revealed large polygonal cells with granular eosinophilic cytoplasm and atrophic overlying epithelium"
explanation: >
This case report directly documents atrophic overlying epithelium as part
of the histopathologic pattern.
- name: Non-neural immunophenotype
description: >
Immunohistochemistry usually distinguishes congenital epulis from adult
granular cell tumor by absent S-100 expression and absent or weak CD68
staining, supporting a non-neural origin.
diagnostic: true
evidence:
- reference: PMID:41925794
reference_title: "Cytoplasmic Granules in Granular Cell Tumor and Congenital Epulis: A Histochemical and Immunohistochemical Note."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "CE, however, lacks S-100 expression and demonstrates absent or weak CD68 staining, favoring a non-neural, likely mesenchymal or hamartomatous origin."
explanation: >
This directly supports the diagnostic non-neural immunophenotypic profile
of congenital epulis.
- reference: PMID:39049934
reference_title: "From prenatal diagnosis to surgical treatment: two case reports of congenital granular cell epulis."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Immunohistochemical analysis showed that vimentin was positive, S-100 protein was negative, and NSE protein and CD68 protein were negative."
explanation: >
The 2024 case report supports the vimentin-positive, S-100-negative
immunophenotype described in the entry.
diagnosis:
- name: Prenatal and neonatal clinical imaging assessment
description: >
Prenatal ultrasound can identify prominent fetal oral masses and guide
delivery planning; neonatal examination then confirms the oral lesion
clinically before excision and pathology.
diagnosis_term:
preferred_term: clinical imaging procedure
term:
id: MAXO:0000005
label: clinical imaging procedure
evidence:
- reference: PMID:39049934
reference_title: "From prenatal diagnosis to surgical treatment: two case reports of congenital granular cell epulis."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Ultrasonic examinations at 34 weeks of gestation revealed prominent oral masses in both fetuses."
explanation: >
This supports prenatal ultrasound as a useful diagnostic detection method.
- reference: PMID:12439158
reference_title: "Obstructive congenital epulis: prenatal diagnosis and perinatal management."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Antepartum ultrasonography demonstrated massive intraoral masses in two fetuses"
explanation: >
This supports antenatal imaging recognition of obstructive intraoral
congenital epulis masses.
- name: Histology and immunohistochemistry confirmation
description: >
Final diagnosis is confirmed on excised tissue using histology and, when
available, immunohistochemistry.
evidence:
- reference: PMID:40860794
reference_title: "Congenital granular cell epulis in a neonate: a case report and review of diagnosis, treatment, and prognosis."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Histological and immunohistochemical analysis confirmed the diagnosis of CGCE."
explanation: >
This directly supports tissue pathology and immunohistochemistry as
confirmatory diagnostic methods.
treatments:
- name: Local surgical excision
description: >
Local excision of the mass is the main treatment when the lesion interferes
with feeding or threatens the airway. Wide destructive margins are generally
not implied by the available case literature.
treatment_term:
preferred_term: surgical excision
term:
id: MAXO:0000447
label: surgical excision
target_phenotypes:
- preferred_term: gingival mass
term:
id: HP:0000168
label: Abnormality of the gingiva
- preferred_term: Feeding difficulties in infancy
term:
id: HP:0008872
label: Feeding difficulties in infancy
evidence:
- reference: PMID:32779496
reference_title: "Large Congenital Epulis: A Neonatal Tumour with Striking Appearance, but Simple Management."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "The mass was excised surgically and baby improved."
explanation: >
This case directly supports surgical excision as effective management for
a large congenital epulis.
- reference: PMID:40860794
reference_title: "Congenital granular cell epulis in a neonate: a case report and review of diagnosis, treatment, and prognosis."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Early diagnosis and surgical treatment of CGCE are essential to avoid functional impairment."
explanation: >
This review/case report supports early surgical treatment to prevent or
relieve functional impairment.
- name: Perinatal supportive and airway planning
description: >
Prenatally detected large oral masses may require multidisciplinary delivery
planning, airway readiness, and temporary feeding support until definitive
excision.
treatment_term:
preferred_term: supportive care
term:
id: MAXO:0000950
label: supportive care
target_phenotypes:
- preferred_term: Feeding difficulties in infancy
term:
id: HP:0008872
label: Feeding difficulties in infancy
- preferred_term: Respiratory distress
term:
id: HP:0002098
label: Respiratory distress
evidence:
- reference: PMID:12439158
reference_title: "Obstructive congenital epulis: prenatal diagnosis and perinatal management."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "A multidisciplinary approach to antenatally identified congenital intraoral masses facilitates care at birth."
explanation: >
This directly supports multidisciplinary perinatal planning for cases
detected before delivery.
- reference: PMID:12439158
reference_title: "Obstructive congenital epulis: prenatal diagnosis and perinatal management."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Feeding was started early, and both infants were discharged after brief hospital stays."
explanation: >
This supports short-term perinatal management focused on safe airway and
early feeding after intervention.
Target disease: Congenital epulis (also called congenital granular cell epulis, congenital gingival granular cell tumor, Neumann tumor) — a rare, benign, neonatal oral soft-tissue tumor-like lesion arising on the gingiva/alveolar ridge, typically present at birth and sometimes detectable prenatally. (han2024fromprenataldiagnosis pages 1-3, mcguire2006pratiqueclinique pages 1-3)
Congenital epulis/congenital granular cell epulis (CGCE) is a benign lesion exclusive to the newborn period, most often on the anterior maxillary alveolar ridge, with a marked female predominance. Etiology/histogenesis remains uncertain; hypotheses span pericytic/fibroblastic/histiocytic/nerve-related or undifferentiated mesenchymal origins, and many authors discuss potential intrauterine hormonal influence (estrogen exposure) to explain both sex bias and postnatal growth arrest/spontaneous regression. Diagnosis is clinicopathologic, supported by characteristic granular-cell histology and a typical immunophenotype (often vimentin-positive, S-100 negative), though recent cases document immunohistochemical variability (e.g., weak S-100/CD68 positivity) and Ki-67 around 15% in at least one case. Primary management is local surgical excision when feeding/airway function is threatened; prognosis is excellent with negligible recurrence and no malignant transformation reported in the retrieved sources. (qin2024aclinicalobservation pages 1-2, han2024fromprenataldiagnosis pages 1-3, mcguire2006pratiqueclinique pages 1-3)
Common synonyms include: - congenital granular cell epulis (CGCE) - congenital epulis - congenital gingival granular cell tumor - congenital granular cell myoblastoma - Neumann (Newmann) tumor
These are explicitly used in 2024 case literature. (qin2024aclinicalobservation pages 1-2, chaudhry2024congenitalepulisreport pages 1-2, han2024fromprenataldiagnosis pages 1-3)
The evidence base is dominated by case reports/series and small retrospective pathology datasets; high-quality population registries and mechanistic molecular studies are limited in the retrieved set. (shuhairi2021aretrospectiveanalysis pages 1-2, han2024fromprenataldiagnosis pages 1-3)
No genetic or environmental protective factors were identified in the retrieved literature.
No gene–environment interaction evidence was identified in the retrieved literature.
Primary impact is feeding/breastfeeding impairment in the newborn period and potential airway management complexity. Postoperative functional recovery (return to oral feeding/breastfeeding) is typically rapid in reported cases. (qin2024aclinicalobservation pages 1-2, braz2022épuliscongénito pages 1-3, mcguire2006pratiqueclinique pages 1-3)
No causal gene has been identified or reported in the retrieved evidence.
No germline or somatic pathogenic variants were reported.
Interpretation: recent work cautions that S-100 alone may be insufficient to distinguish CGCE from adult granular cell tumor because some CGCE cases may show S-100 positivity. (qin2024aclinicalobservation pages 2-3, qin2024aclinicalobservation pages 1-2)
No consistent environmental triggers, toxins, infections, or lifestyle associations were identified in the retrieved literature. A 2024 case report explicitly notes absence of familial tendency or teratogen association in its discussion. (haghegh2024congenitalepulisa pages 4-6)
Estimates vary across reports: - Incidence: approximately 0.0006% cited in 2024 literature. (han2024fromprenataldiagnosis pages 1-3, haghegh2024congenitalepulisa pages 1-4) - Alternative incidence estimate: ~1 per 6,000,000 in a 2022 neonatal report. (braz2022épuliscongénito pages 1-3) - Another literature-derived estimate: 6–9 cases per million births in a review-style summary. (vera2026épuliscongénitocaso pages 1-4)
Sex ratio: strong female predominance, commonly 8–10:1 or 10:1 female:male. (han2024fromprenataldiagnosis pages 1-3, mcguire2006pratiqueclinique pages 1-3)
Site distribution: maxilla predominates over mandible, often cited as ~3× more common in the maxilla (or ratios 2:1–3:1 across reports). (qin2024aclinicalobservation pages 1-2, mcguire2006pratiqueclinique pages 1-3)
Pathology service-based frequency (not population incidence): In a 51-year Malaysian oral pathology series (≤2 years old), congenital epulis comprised 11/27 (40.7%) of newborn oral/maxillofacial biopsy diagnoses, showing it is a major neonatal indication for biopsy among rare lesions in that dataset. (shuhairi2021aretrospectiveanalysis pages 4-5)
Clinical suspicion arises from the classic newborn gingival mass, often pedunculated and well circumscribed; diagnosis is typically confirmed histologically. (braz2022épuliscongénito pages 1-3, mcguire2006pratiqueclinique pages 1-3)
Prenatal imaging (2023–2024 emphasis): - Prenatal ultrasound can show a mass protruding from the fetal mouth in the third trimester; multidisciplinary planning is used to manage delivery/anesthesia risks. (han2024fromprenataldiagnosis pages 1-3, han2024fromprenataldiagnosis pages 3-4) - Prenatal MRI complements ultrasound by defining relationships to palate/gingiva and tissue characteristics; one 2024 report details T1/T2 and diffusion-weighted findings and discusses the role of Doppler flow in differential diagnosis. (qin2024aclinicalobservation pages 1-2, qin2024aclinicalobservation pages 2-3)
Visual evidence (prenatal imaging/IHC panels): Han et al. include prenatal sonography and immunohistochemistry panels (vimentin staining, S-100 negativity) in figures/tables. (han2024fromprenataldiagnosis media e73f6ade)
Typical histology: sheets/nests/ribbons of granular cells with abundant eosinophilic granular cytoplasm, prominent capillaries/vascular stroma, and thin overlying squamous epithelium without pseudoepitheliomatous hyperplasia. (qin2024aclinicalobservation pages 2-3, mcguire2006pratiqueclinique pages 1-3, chaudhry2024congenitalepulisreport pages 1-2)
Differentials include fetal/neonatal oral teratoma/epignathus, hemangioma/vascular malformation, melanotic neuroectodermal tumor of infancy, rhabdomyosarcoma, dermoid cyst, fibroma, and granular cell tumor. (qin2024aclinicalobservation pages 2-3, oriaifo2024congenitalepulisin pages 1-3, mcguire2006pratiqueclinique pages 1-3)
A clinical trials registry search in the current tool environment did not identify relevant interventional trials for congenital epulis/CGCE. (shuhairi2021aretrospectiveanalysis pages 1-2)
No naturally occurring non-human cases or veterinary relevance were identified in the retrieved evidence.
No established animal or experimental model organism systems were identified in the retrieved evidence.
| Identifier system | Term/code (if present) | Notes | Key supporting citation IDs |
|---|---|---|---|
| MeSH | gingival neoplasms/complications; gingival neoplasms/congenital; granular cell tumor/congenital; infant, newborn |
Explicit MeSH indexing reported in a peer-reviewed dental article on congenital epulis. | (mcguire2006pratiqueclinique pages 1-3, mcguire2006congenitalepulisa pages 1-3) |
| WHO naming | congenital granular cell epulis |
A 2024 case report states this is the term used by WHO; literature also uses congenital epulis. |
(oriaifo2024congenitalepulisin pages 1-3) |
| ICD-10 / ICD-11 | No specific code identified in retrieved sources | Available texts did not provide an explicit ICD-10 or ICD-11 code for congenital epulis; coding remains unresolved in this evidence set. | (mcguire2006congenitalepulisa pages 3-4, qin2024aclinicalobservation pages 1-2, braz2022épuliscongénito pages 1-3, lacerda2025congenitalepulidisa pages 10-10) |
| Synonym / terminology | congenital epulis |
Most commonly used umbrella term in clinical literature; refers to a rare benign neonatal gingival/alveolar lesion. | (mcguire2006congenitalepulisa pages 3-4, qin2024aclinicalobservation pages 1-2, chaudhry2024congenitalepulisreport pages 1-2, han2024fromprenataldiagnosis pages 1-3) |
| Synonym / terminology | congenital granular cell epulis (CGCE) |
Common recent preferred term, especially in 2024 prenatal-management and pathology reports. | (qin2024aclinicalobservation pages 1-2, han2024fromprenataldiagnosis pages 1-3) |
| Synonym / terminology | Neumann tumor / Newmann’s tumor |
Historical eponym tracing to the first description in 1871. | (mcguire2006congenitalepulisa pages 3-4, chaudhry2024congenitalepulisreport pages 1-2, han2024fromprenataldiagnosis pages 1-3, braz2022épuliscongénito pages 1-3) |
| Synonym / terminology | congenital gingival granular cell tumor |
Frequently used pathology/clinical synonym emphasizing gingival origin. | (chaudhry2024congenitalepulisreport pages 1-2, oriaifo2024congenitalepulisin pages 1-3) |
| Synonym / terminology | congenital granular cell myoblastoma |
Older synonym still encountered in case reports and reviews. | (mcguire2006congenitalepulisa pages 3-4, chaudhry2024congenitalepulisreport pages 1-2) |
| Incidence estimate | 0.0006% |
Reported in 2024/2025 case literature and review-style discussion. | (haghegh2024congenitalepulisa pages 1-4, han2024fromprenataldiagnosis pages 1-3) |
| Incidence estimate | ~1/6,000,000 |
Alternative estimate reported in a 2022 Spanish-language neonatal case report. | (braz2022épuliscongénito pages 1-3) |
| Incidence estimate | 6–9 cases per million births |
Reported in review-style summary evidence; should be treated as literature-derived estimate rather than registry-based incidence. | (vera2026épuliscongénitocaso pages 1-4) |
| Sex ratio | Female predominance 8–10:1 |
Strong and consistent female excess across modern and older case literature. | (chaudhry2024congenitalepulisreport pages 1-2, han2024fromprenataldiagnosis pages 1-3, oriaifo2024congenitalepulisin pages 1-3, braz2022épuliscongénito pages 1-3) |
| Sex ratio | Female predominance 10:1 |
Commonly cited estimate in reviews/case discussions. | (haghegh2024congenitalepulisa pages 1-4, mcguire2006congenitalepulisa pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
| Site distribution | Maxilla:mandible 2:1 |
One recent prenatal/postnatal management report gives an approximate 2:1 maxillary predominance. | (qin2024aclinicalobservation pages 1-2) |
| Site distribution | Maxilla:mandible 2–3:1 |
2022 case report describes upper-jaw predominance in a 2–3:1 ratio. | (braz2022épuliscongénito pages 1-3) |
| Site distribution | Maxilla:mandible 3:1 / maxilla 3× mandible |
Frequently cited distribution in 2006 and 2024 literature; lesion usually arises on anterior maxillary alveolar ridge. | (haghegh2024congenitalepulisa pages 4-6, haghegh2024congenitalepulisa pages 1-4, mcguire2006congenitalepulisa pages 1-3, han2024fromprenataldiagnosis pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
| Multiplicity | Multiple lesions in ~5%–16% or ~10% of cases |
Most cases are solitary; multifocal lesions are uncommon but well documented. | (qin2024aclinicalobservation pages 1-2, chaudhry2024congenitalepulisreport pages 1-2, han2024fromprenataldiagnosis pages 1-3) |
Table: This table summarizes the main identifiers, synonyms, and core epidemiologic estimates for congenital epulis from the retrieved evidence. It is useful for harmonizing disease terminology and for quickly comparing commonly cited incidence, sex-ratio, and site-distribution figures.
| Domain | Finding | Typical timing/onset | Quantitative stats (if available) | Ontology term suggestions (HPO/GO/CL/UBERON/MAXO as appropriate) | Key citations |
|---|---|---|---|---|---|
| Phenotype | Benign congenital oral/alveolar soft-tissue mass; usually smooth, pink/red, sessile or pedunculated, often lobulated | Congenital; present at birth or detected in late 3rd trimester prenatally | Size ranges from millimeters to ~9 cm in literature; examples 3×2×2 cm, 3×4×3 cm, 5.0×4.5×3.0 cm | HPO: Congenital onset (HP:0003577), Gingival mass/oral cavity mass (suggested); UBERON: gingiva, maxillary alveolar ridge, mandibular alveolar ridge | (qin2024aclinicalobservation pages 1-2, chaudhry2024congenitalepulisreport pages 1-2, han2024fromprenataldiagnosis pages 1-3, oriaifo2024congenitalepulisin pages 1-3, braz2022épuliscongénito pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
| Phenotype | Predominant location is anterior maxillary alveolar ridge; mandibular gingiva less common; tongue rare | Present at birth; prenatal detection possible from ~25–26 weeks | Maxilla more common than mandible by ~2:1, 2–3:1, or 3:1 across reports | UBERON: maxillary alveolar ridge, mandibular alveolar ridge, gingiva, tongue | (qin2024aclinicalobservation pages 1-2, han2024fromprenataldiagnosis pages 1-3, oriaifo2024congenitalepulisin pages 1-3, braz2022épuliscongénito pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
| Phenotype | Strong female predominance | Congenital/neonatal | Female:male ratio ~8–10:1 or 10:1 | HPO: Female-limited/sex-biased occurrence (suggested epidemiologic annotation) | (chaudhry2024congenitalepulisreport pages 1-2, han2024fromprenataldiagnosis pages 1-3, oriaifo2024congenitalepulisin pages 1-3, braz2022épuliscongénito pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
| Phenotype | Usually solitary lesion, but multifocal disease occurs | Congenital/neonatal | Multiple lesions reported in ~5–16% or ~10% of cases | HPO: Multiple oral masses (suggested) | (qin2024aclinicalobservation pages 1-2, chaudhry2024congenitalepulisreport pages 1-2, han2024fromprenataldiagnosis pages 1-3) |
| Phenotype | Feeding/suckling impairment due to oral mass | Immediate neonatal period | Common functional consequence in large lesions; case reports required NG feeds/support | HPO: Feeding difficulties (HP:0011968), Poor suck (HP:0002033) | (chaudhry2024congenitalepulisreport pages 1-2, han2024fromprenataldiagnosis pages 3-4, oriaifo2024congenitalepulisin pages 1-3, braz2022épuliscongénito pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
| Phenotype | Respiratory compromise/airway obstruction can occur with large tumors, though many neonates remain stable | Immediate neonatal period | Qualitative risk; no pooled percentage in retrieved evidence | HPO: Respiratory distress (HP:0002098), Airway obstruction (suggested) | (qin2024aclinicalobservation pages 2-3, chaudhry2024congenitalepulisreport pages 1-2, oriaifo2024congenitalepulisin pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
| Phenotype | Growth pattern: prenatal enlargement in 3rd trimester; usually stops growing after birth; rare spontaneous regression reported | Late pregnancy to neonatal period | Prenatal diagnosis as early as 25–26 weeks; spontaneous regression uncommon but documented | HPO: Congenital onset (HP:0003577) | (qin2024aclinicalobservation pages 1-2, chaudhry2024congenitalepulisreport pages 1-2, han2024fromprenataldiagnosis pages 1-3, braz2022épuliscongénito pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
| Phenotype | Newborn oral pathology series shows congenital epulis is an important neonatal biopsy diagnosis | Newborn period | In a 51-year Malaysian series, congenital epulis accounted for 11/27 (40.7%) of newborn oral/maxillofacial biopsy diagnoses; 13 total cases (4.5% of all specimens ≤2 years) | Disease annotation / epidemiology field | (shuhairi2021aretrospectiveanalysis pages 1-2, shuhairi2021aretrospectiveanalysis pages 4-5) |
| Diagnosis | Prenatal ultrasound can identify protruding oral mass; MRI helps define relation to palate/gingiva and plan delivery/airway management | 25–39 weeks gestation | Prenatal detection reported from ~25–26 weeks; cases detected at 34–34.5 and 39 weeks | UBERON: oral cavity, palate, upper lip; Diagnostic imaging annotation | (qin2024aclinicalobservation pages 2-3, qin2024aclinicalobservation pages 1-2, han2024fromprenataldiagnosis pages 3-4, han2024fromprenataldiagnosis pages 1-3, braz2022épuliscongénito pages 1-3) |
| Diagnosis | Gross pathology: well-circumscribed/polypoid lesion with smooth mucosal covering; yellow-white to gray-yellow cut surface possible | At birth / post-excision | Qualitative | UBERON: gingiva, oral mucosa | (qin2024aclinicalobservation pages 2-3, chaudhry2024congenitalepulisreport pages 1-2, han2024fromprenataldiagnosis pages 3-4, oriaifo2024congenitalepulisin pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
| Diagnosis | Histology: sheets/nests/ribbons of large polygonal granular cells with abundant eosinophilic granular cytoplasm and small central/eccentric nuclei; rich vascular stroma; thin squamous epithelium without pseudoepitheliomatous hyperplasia | Postnatal biopsy/excision specimen | No mitoses typically reported; PAS positivity reported in one case | GO: cytoplasmic granule; CL: mesenchymal cell (suggested); Tissue: stratified squamous epithelium, stromal capillaries | (qin2024aclinicalobservation pages 2-3, qin2024aclinicalobservation pages 1-2, chaudhry2024congenitalepulisreport pages 1-2, oriaifo2024congenitalepulisin pages 1-3, braz2022épuliscongénito pages 1-3, mcguire2006pratiqueclinique pages 1-3, mcguire2006congenitalepulisa pages 3-4) |
| Diagnosis | Immunohistochemistry typically supports mesenchymal/non-neural profile | Postnatal tissue diagnosis | Common pattern: vimentin+, S-100−; Han 2024 also NSE− and CD68− | GO: vimentin intermediate filament organization (suggested); CL: undifferentiated mesenchymal cell (suggested) | (han2024fromprenataldiagnosis pages 1-3, han2024fromprenataldiagnosis media e73f6ade) |
| Diagnosis | IHC variability exists; weak S-100 and CD68 positivity can occur | Postnatal tissue diagnosis | Qin 2024: S100(+), CD68(+), vimentin(+), CR(+), SOX10−, NSE−, HMB45−, CK−, CEA−, SMA−, desmin−, Ki-67 ~15%+ | GO: cell proliferation (GO:0008283) for Ki-67 context | (qin2024aclinicalobservation pages 1-2, qin2024aclinicalobservation pages 2-3) |
| Diagnosis | Differential diagnosis includes teratoma/epignathus, hemangioma, lymphangioma, melanotic neuroectodermal tumor of infancy, rhabdomyosarcoma, dermoid cyst, fibroma, granular cell tumor | Prenatal and neonatal diagnostic workup | Qualitative | HPO/diagnostic differential field; UBERON: oral cavity, maxilla | (qin2024aclinicalobservation pages 2-3, oriaifo2024congenitalepulisin pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
| Diagnosis | Genetic findings are not established; no causal gene identified in retrieved evidence | N/A | Prenatal NIPT low-risk for trisomies 21/18/13 in one 2024 case; no familial pattern in reported cases | No established causal gene/variant annotation | (qin2024aclinicalobservation pages 1-2, han2024fromprenataldiagnosis pages 1-3) |
| Treatment | Primary treatment is complete local surgical excision, typically under general anesthesia; electrocautery or pedicle ligation may be used | Neonatal period, often within first days of life when feeding/airway affected | Surgery at day 1–3 in several cases; minimal bleeding reported | MAXO: Surgical excision of oral lesion (suggested), Airway management (suggested), Enteral feeding support (suggested) | (qin2024aclinicalobservation pages 1-2, chaudhry2024congenitalepulisreport pages 1-2, han2024fromprenataldiagnosis pages 3-4, oriaifo2024congenitalepulisin pages 1-3, braz2022épuliscongénito pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
| Treatment | Multidisciplinary prenatal/postnatal management is increasingly reported for prenatally diagnosed cases | Late pregnancy through neonatal care | Teams included obstetrics, pediatricians, anesthesiology, oral/maxillofacial surgery; cesarean selected in some large lesions | MAXO: Multidisciplinary care planning (suggested), Cesarean delivery when indicated (suggested) | (qin2024aclinicalobservation pages 2-3, qin2024aclinicalobservation pages 1-2, han2024fromprenataldiagnosis pages 3-4, han2024fromprenataldiagnosis pages 1-3) |
| Treatment | Supportive care may include nasogastric feeding, IV fluids, and oral wound care before/after surgery | Immediate neonatal period | Qualitative | MAXO: Nasogastric tube feeding, Intravenous fluid administration, Postoperative wound care (suggested) | (chaudhry2024congenitalepulisreport pages 1-2, oriaifo2024congenitalepulisin pages 1-3, braz2022épuliscongénito pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
| Prognosis | Prognosis is excellent; lesion is benign with no malignant transformation reported in retrieved sources | Short- and long-term after excision | Qualitative; literature consistently describes negligible recurrence/malignant transformation | Prognosis field | (han2024fromprenataldiagnosis pages 1-3, oriaifo2024congenitalepulisin pages 1-3, mcguire2006pratiqueclinique pages 1-3, mcguire2006congenitalepulisa pages 3-4) |
| Prognosis | Recurrence after excision is very uncommon/not reported in cited case literature | Follow-up months to 1 year and literature summaries | No recurrence at 6 months (Qin 2024); no recurrence at 1 year in both Chaudhry 2024 cases; no recurrence reported in review-style summaries | Outcome annotation | (qin2024aclinicalobservation pages 1-2, chaudhry2024congenitalepulisreport pages 1-2) |
| Prognosis | Functional recovery after treatment is usually rapid, with restoration of feeding/breastfeeding | Hours to days after surgery | Postoperative feeding resumed within hours to 2 days in case reports | HPO improvement: Feeding difficulties resolved (suggested) | (qin2024aclinicalobservation pages 1-2, han2024fromprenataldiagnosis pages 3-4, oriaifo2024congenitalepulisin pages 1-3, braz2022épuliscongénito pages 1-3, mcguire2006pratiqueclinique pages 1-3) |
Table: This table consolidates the main phenotype, diagnostic, treatment, and prognosis findings for congenital epulis/congenital granular cell epulis from the retrieved case reports and retrospective study. It is useful for rapid disease knowledge base curation, including ontology suggestions and directly traceable citation support.
References
(han2024fromprenataldiagnosis pages 1-3): Yibing Han, Wen Qiu, Yu Zhang, Mengmeng Hua, Shaohua Liu, and Zuoqing Dong. From prenatal diagnosis to surgical treatment: two case reports of congenital granular cell epulis. Pathology and Oncology Research, Jul 2024. URL: https://doi.org/10.3389/pore.2024.1611834, doi:10.3389/pore.2024.1611834. This article has 5 citations.
(mcguire2006pratiqueclinique pages 1-3): TP McGuire, PP Gomes, MM Freilich, and GKB Sándor. Pratiqueclinique. Unknown journal, 2006.
(qin2024aclinicalobservation pages 1-2): Feng Qin, Xiaochuan Xu, Yong Yang, Qiong Li, Ting Huang, Xiaoyan Chen, Xiaolan Chen, Yamin Liu, and Gongli Chen. A clinical observation report on prenatal management and postnatal treatment of congenital granular cell epulis. Maternal-Fetal Medicine, 6:102-105, Apr 2024. URL: https://doi.org/10.1097/fm9.0000000000000225, doi:10.1097/fm9.0000000000000225. This article has 1 citations.
(chaudhry2024congenitalepulisreport pages 1-2): Ali Raza Chaudhry, Rumaisaa Saman, Muhammad Umar Nisar, Khawar Abbas, and Samer Sikander. Congenital epulis: report of two cases. Journal of Pediatric and Adolescent Surgery, 1:117-119, Jul 2024. URL: https://doi.org/10.46831/jpas.v1i2.99, doi:10.46831/jpas.v1i2.99. This article has 3 citations.
(oriaifo2024congenitalepulisin pages 1-3): Sylvester Oriaifo, Osasere Andrew Eweka, and Kenneth Atoe. Congenital epulis in a newborn – a case report in benin city, nigeria. European Journal of Clinical and Experimental Medicine, 22:965-968, Dec 2024. URL: https://doi.org/10.15584/ejcem.2024.4.6, doi:10.15584/ejcem.2024.4.6. This article has 1 citations.
(mcguire2006congenitalepulisa pages 3-4): TP McGuire, PP Gomes, and MM Freilich. Congenital epulis: a surprise in the neonate. Unknown journal, 2006.
(braz2022épuliscongénito pages 1-3): Juliana Braz, Helena Sobrero, Jennise De los Santos, Mario Moraes, and Sheila Jacobsen. Épulis congénito. Archivos de Pediatría del Uruguay, May 2022. URL: https://doi.org/10.31134/ap.93.1.15, doi:10.31134/ap.93.1.15. This article has 0 citations.
(shuhairi2021aretrospectiveanalysis pages 1-2): Nadia Najwa Binti Shuhairi, Ajura Bt Abdul Jalil, Shin‐Hin Lau, Sumarni Bt Mohd Ghazali, and Chee Cheong Kee. A retrospective analysis of oral and maxillofacial biopsied specimens in malaysian newborns and infants. International Journal of Paediatric Dentistry, 31:496-503, Sep 2021. URL: https://doi.org/10.1111/ipd.12719, doi:10.1111/ipd.12719. This article has 6 citations and is from a domain leading peer-reviewed journal.
(qin2024aclinicalobservation pages 2-3): Feng Qin, Xiaochuan Xu, Yong Yang, Qiong Li, Ting Huang, Xiaoyan Chen, Xiaolan Chen, Yamin Liu, and Gongli Chen. A clinical observation report on prenatal management and postnatal treatment of congenital granular cell epulis. Maternal-Fetal Medicine, 6:102-105, Apr 2024. URL: https://doi.org/10.1097/fm9.0000000000000225, doi:10.1097/fm9.0000000000000225. This article has 1 citations.
(haghegh2024congenitalepulisa pages 4-6): Khadija Haghegh and Mohammed Almughrabi. Congenital epulis: a case report. Journal, Jul 2024. URL: https://doi.org/10.60692/z0ew7-7n257, doi:10.60692/z0ew7-7n257. This article has 0 citations.
(haghegh2024congenitalepulisa pages 1-4): Khadija Haghegh and Mohammed Almughrabi. Congenital epulis: a case report. Journal, Jul 2024. URL: https://doi.org/10.60692/z0ew7-7n257, doi:10.60692/z0ew7-7n257. This article has 0 citations.
(vera2026épuliscongénitocaso pages 1-4): RMCV Vera, TLP Mawyin, and RFA Bajaña. Épulis congénito: caso clínico y revisión de la literatura. Unknown journal, 2026.
(shuhairi2021aretrospectiveanalysis pages 4-5): Nadia Najwa Binti Shuhairi, Ajura Bt Abdul Jalil, Shin‐Hin Lau, Sumarni Bt Mohd Ghazali, and Chee Cheong Kee. A retrospective analysis of oral and maxillofacial biopsied specimens in malaysian newborns and infants. International Journal of Paediatric Dentistry, 31:496-503, Sep 2021. URL: https://doi.org/10.1111/ipd.12719, doi:10.1111/ipd.12719. This article has 6 citations and is from a domain leading peer-reviewed journal.
(han2024fromprenataldiagnosis pages 3-4): Yibing Han, Wen Qiu, Yu Zhang, Mengmeng Hua, Shaohua Liu, and Zuoqing Dong. From prenatal diagnosis to surgical treatment: two case reports of congenital granular cell epulis. Pathology and Oncology Research, Jul 2024. URL: https://doi.org/10.3389/pore.2024.1611834, doi:10.3389/pore.2024.1611834. This article has 5 citations.
(han2024fromprenataldiagnosis media e73f6ade): Yibing Han, Wen Qiu, Yu Zhang, Mengmeng Hua, Shaohua Liu, and Zuoqing Dong. From prenatal diagnosis to surgical treatment: two case reports of congenital granular cell epulis. Pathology and Oncology Research, Jul 2024. URL: https://doi.org/10.3389/pore.2024.1611834, doi:10.3389/pore.2024.1611834. This article has 5 citations.
(mcguire2006congenitalepulisa pages 1-3): TP McGuire, PP Gomes, and MM Freilich. Congenital epulis: a surprise in the neonate. Unknown journal, 2006.
(lacerda2025congenitalepulidisa pages 10-10): ACR Lacerda, KAF Cruz, and EHBS Lima. Congenital epulidis: a literature review-from diagnosis to treatment. Unknown journal, 2025.