Congenital epulis: a rare diagnosis in paediatric surgery

Congenital epulis of the newborn is a rare tumour which is usually benign. The first description of a case is attributed to Neumann in 1871. The word "epulis" is derived from Greek and means "on the gum" or "gum boil". Epulis is also known as a congenital gingival granular cell tumour because of its histological features. Since 1871, 216 cases have been reported. Female babies are affected 8-10 times more often than males. Epulis is located on the maxillary ridge twice as often as on the mandible, mostly as single tumours but rarely as multiple tumours. Macroscopically, epulis is a pedunculated tumour with a smooth or lobulated surface. The basis of the tumour is the alveolar mucosa. The size varies from a few millimetres to 9 cm in diameter. After birth, the tumour normally does not increase in size. Microscopic examination shows a central mass of granular cells. This mass is surrounded by a stratified squamous mucosa. The histogenesis of the tumour is unknown. Spontaneous regression of congenital epulis has been reported in four cases. However, surgical excision is generally indicated due to interference with feeding or respiration. Recurrence of the tumour after surgery has not been reported yet.