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Congenital Epulis

Congenital Epulis (Congenital Granular Cell Epulis; Neumann Tumor): Disease Characteristics Research Report

2026-05-09
Falcon MONDO:0015528 Model: Edison Scientific Literature 24 citations

Congenital Epulis (Congenital Granular Cell Epulis; Neumann Tumor): Disease Characteristics Research Report

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)

Executive summary (current understanding)

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)

1. Disease information

1.1 Definition / overview

1.2 Key identifiers (controlled vocabularies)

  • MeSH (explicit in retrieved literature): gingival neoplasms/complications; gingival neoplasms/congenital; granular cell tumor/congenital; infant, newborn. (mcguire2006pratiqueclinique pages 1-3)
  • WHO terminology: A 2024 case report states that “congenital granular cell epulis” is the term used by WHO. (oriaifo2024congenitalepulisin pages 1-3)
  • ICD-10/ICD-11 / SNOMED CT / MONDO / Orphanet / OMIM: No explicit codes/IDs were found in the retrieved sources used for this report (therefore not assigned here). (mcguire2006congenitalepulisa pages 3-4, braz2022épuliscongénito pages 1-3)

1.3 Synonyms / alternative names

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)

1.4 Evidence source type

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)

2. Etiology

2.1 Disease causal factors

  • Etiology remains unknown/controversial. Multiple origin hypotheses are enumerated in 2024 work: pericyte, fibroblast, histiocyte, nerve-related, and undifferentiated mesenchymal cells. (han2024fromprenataldiagnosis pages 1-3)
  • An older peer-reviewed dental report describes histogenesis as uncertain and suggests a “non-neoplastic, degenerative or reactive lesion.” (mcguire2006congenitalepulisa pages 3-4)

2.2 Risk factors

2.3 Protective factors

No genetic or environmental protective factors were identified in the retrieved literature.

2.4 Gene–environment interactions

No gene–environment interaction evidence was identified in the retrieved literature.

3. Phenotypes

3.1 Core phenotype spectrum

3.2 Phenotype timing/severity/progression

3.3 Frequency among affected individuals (when available)

3.4 Quality-of-life / functional impact

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)

3.5 Suggested HPO terms (non-exhaustive)

  • Congenital onset (HP:0003577) (general)
  • Feeding difficulties (HP:0011968)
  • Poor suck (HP:0002033)
  • Respiratory distress (HP:0002098) (if airway compromise)
  • Oral cavity mass / Gingival mass (suggested; verify exact HPO IDs during curation)

4. Genetic / molecular information

4.1 Causal genes

No causal gene has been identified or reported in the retrieved evidence.

4.2 Pathogenic variants

No germline or somatic pathogenic variants were reported.

4.3 Genetic testing evidence in retrieved literature

  • A 2024 prenatal management report states noninvasive prenatal genetic testing was low-risk for trisomies 21/18/13 in an affected pregnancy. This does not imply a genetic cause; it reflects normal aneuploidy screening in that case. (qin2024aclinicalobservation pages 1-2)

4.4 Immunophenotype / molecular markers (diagnostic)

  • Typical immunophenotype in several recent cases: vimentin positive, S-100 negative, with NSE and CD68 negative in at least one 2024 report. (han2024fromprenataldiagnosis pages 1-3)
  • Variability exists: a 2024 report documents weak S-100 and CD68 positivity, vimentin positivity, SOX-10 negative, NSE negative, and Ki-67 ~15% positive. (qin2024aclinicalobservation pages 1-2)

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)

5. Environmental information

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)

6. Mechanism / pathophysiology

6.1 Current mechanistic hypotheses

  • Histogenesis is unclear/controversial with multiple proposed cellular origins (pericyte, fibroblast, histiocyte, nerve-related, undifferentiated mesenchymal). (han2024fromprenataldiagnosis pages 1-3)
  • Hormonal influence model: intrauterine estrogen exposure is discussed as a prevailing hypothesis; postpartum hormonal decline may halt growth and could explain rare regression. (qin2024aclinicalobservation pages 1-2)

6.2 Causal chain (working model; evidence-limited)

  1. In utero trigger (hypothesized hormonal milieu and/or mesenchymal developmental program) →
  2. Localized proliferation/differentiation of granular cells in gingival/alveolar mucosa →
  3. Exophytic gingival mass (pedunculated/sessile) →
  4. Mechanical functional effects (feeding difficulty, possible airway compromise) in the newborn. (qin2024aclinicalobservation pages 1-2, chaudhry2024congenitalepulisreport pages 1-2, mcguire2006pratiqueclinique pages 1-3)

6.3 Suggested GO / CL terms (for curation; evidence-limited)

7. Anatomical structures affected

7.1 Primary anatomical sites

7.2 Suggested UBERON terms (examples; verify IDs during curation)

  • Gingiva
  • Maxillary alveolar ridge
  • Mandibular alveolar ridge
  • Oral cavity
  • Hard palate / upper lip (relevant to lesion proximity on imaging in some cases) (qin2024aclinicalobservation pages 1-2)

8. Temporal development

9. Inheritance and population

9.1 Epidemiology (statistics)

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)

9.2 Inheritance pattern

10. Diagnostics

10.1 Clinical diagnosis

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)

10.2 Imaging

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)

10.3 Histopathology

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)

10.4 Immunohistochemistry

10.5 Differential diagnosis

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)

11. Outcome / prognosis

12. Treatment

12.1 Standard of care: surgery

12.2 Supportive management

12.3 Observation/spontaneous regression

12.4 Clinical trials

A clinical trials registry search in the current tool environment did not identify relevant interventional trials for congenital epulis/CGCE. (shuhairi2021aretrospectiveanalysis pages 1-2)

12.5 Suggested MAXO terms (examples; verify IDs during curation)

  • Surgical excision (oral lesion)
  • Airway management / endotracheal intubation (perioperative)
  • Enteral feeding via nasogastric tube
  • Prenatal multidisciplinary care planning

13. Prevention

14. Other species / natural disease

No naturally occurring non-human cases or veterinary relevance were identified in the retrieved evidence.

15. Model organisms

No established animal or experimental model organism systems were identified in the retrieved evidence.

Key evidence tables (for knowledge-base population)

Table (click to expand)
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.

Table (click to expand)
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.

Recent developments (2023–2024 prioritized) and real-world implementations

  1. Prenatal detection and multidisciplinary perinatal planning is a recurring theme in 2024 reports, supporting real-world implementation of fetal imaging (ultrasound/MRI) to guide delivery route and neonatal airway/feeding readiness. (qin2024aclinicalobservation pages 1-2, han2024fromprenataldiagnosis pages 1-3)
  2. Immunohistochemistry variability (weak S-100/CD68 positivity in CGCE) is emphasized in 2024 literature, refining diagnostic practice away from relying on S-100 alone. (qin2024aclinicalobservation pages 1-2)
  3. Post-excision outcomes (rapid return to feeding and no recurrence at 6–12 months) are reiterated in 2024 case reports, supporting early functional restoration as a practical clinical goal. (qin2024aclinicalobservation pages 1-2, chaudhry2024congenitalepulisreport pages 1-2)

Direct quotes from abstracts (where available in retrieved texts)

Evidence limitations

  • The retrieved evidence set did not contain MONDO/Orphanet/OMIM/ICD-11 codes or a definitive ICD-10 mapping for congenital epulis, nor did it provide causal genes or population-based incidence estimates from registries; most numeric estimates are literature-derived and may vary by source. (mcguire2006congenitalepulisa pages 3-4, vera2026épuliscongénitocaso pages 1-4, braz2022épuliscongénito pages 1-3)

References

  1. (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.

  2. (mcguire2006pratiqueclinique pages 1-3): TP McGuire, PP Gomes, MM Freilich, and GKB Sándor. Pratiqueclinique. Unknown journal, 2006.

  3. (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.

  4. (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.

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  14. (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.

  15. (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.

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  17. (lacerda2025congenitalepulidisa pages 10-10): ACR Lacerda, KAF Cruz, and EHBS Lima. Congenital epulidis: a literature review-from diagnosis to treatment. Unknown journal, 2025.