Epulis presenting as congenital multiple polypoidal oral mass lesion: A surprising case report

Abstract

A newborn infant with congenital epulis (CE) can be a striking miserable sight for both parents and health care professionals involved in neonatal care. These tumours of the infant mouth can be remarkably large, occupying much of the oral cavity and posing a risk of airway obstruction or interfering with feeding with marked facial deformity. Neumann first described congenital epulis of newborn in 1871. It is most frequently located on the anterior maxillary alveolar ridge with slight female predilection. It clinically appears as a pedunculated protuberant mass. In cases with large lesions, mechanical oral and nasal obstruction can impair fetal deglutition and neonatal respiratory efforts resulting in polyhydramnios prenatally or respiratory impairment postnatally. Histologically Congenital epulis shows characteristic large cells with granular cytoplasm and spindle cells resembling fibroblasts. The exact histogenesis is still uncertain, various theories of origin are epithelial, undifferentiated mesenchymal cells, pericytes, fibroblast, smooth muscle cells and nerve related cells. Herein we report a newborn female child with Multiple Congenital epulis arising from maxilla and mandible with investigation, management and follow-up.