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Wednesday, September 12, 2012

Congenital Epulis ( Gingival granular cell tumour ) of the Newborn


Epulis is a rare tumor of the newborn, also known as granular cell tumor of the newborn or Neumann's tumor. This tumor arises from the mucosa of the gingiva, most commonly from the anterior part of the maxillary alveolar ridge, and is typically seen as a mass protruding out of the newborn child's mouth, which may interfere with respiration or feeding. Epulis is seen only in the newborn and is a different entity from other granular cell tumors. The tumor has a marked female preponderance of 8:1. The recommended treatment is prompt surgical resection. Recurrences of the tumor and damage to future dentition have not been reported, suggesting that radical excision is not warranted.
A newborn female with such a mass is described. The tumor was resected using a carbon dioxide laser; the postoperative course was uneventful. On histologic examination, it was composed of diffuse sheets and clusters of polygonal cells containing small round to oval nuclei and abundant coarsely granular cytoplasm. The tumor cells stained positive for vimentin, and negative for S100-protein, actin, desmin, laminin, keratin, estrogen, and progesterone receptors. Electron microscopic examination showed granular cells containing heterogeneous electron-dense granules, lysosomes, and cytoplasmic lipid droplets. The clinical and microscopic features of such tumors are reviewed. 
                                    Epulis, or congenital granular cell tumor (GCT), is a rare tumor of the newborn. It is seen as a mass arising in the mouth from the alveolar ridge; this mass may interfere with respiration or feeding. A case of congenital epulis is reported; the tumor was resected using a carbon dioxide laser. The clinical aspects as well as the morphologic, histologic, and electron microscopic features of this lesion and its treatment are reviewed. 
Although the clinical presence of the congenital epulis may frigten parents,it ceases to grow following birth and is entirely benign,with some cases undergoing spontaneous involution.The usual treatement is simple surgical excision,with care taken not to interfere with the developing dentition.There is no propensity for recurrence , even in those in which the lesion is incompletely removed.

Ref: Dentistry for child and adolescent .

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