Minimal intervention approach for a lesion suggestive of congenital granular cell epulis: a case report

Congenital granular cell epulis (CGCE), also known as newborn epulis and Neumann tumor, is a rare benign tumor characterized by neoplastic connective tissue proliferation. It typically occurs as a single mass in the maxillary anterior region of the alveolar ridge and seems to have a predilection for females. This case report describes a minimal intervention approach to CGCE that focused on the biopsychosocial well-being of the infant and family. Clinical examination of a 3-month-old male infant with gingival swelling that had been present since birth revealed a reddish, multilobulated, sessile lesion on the anteroinferior alveolar ridge. The lesion had a smooth surface, regular contours, and a gingiva-like consistency. No other symptoms or systemic comorbidities were reported, and the infant's respiratory and feeding functions were unaffected. A conservative management approach with clinical monitoring was chosen. At 6 months, partial resolution was noted, and by 9 months, the lesion had completely resolved, coinciding with the eruption of the mandibular incisors. Although CGCE commonly stabilizes postnatally, surgical excision is frequently performed, especially when it affects respiration or feeding. This case demonstrates an uncommon mandibular CGCE in a male patient and highlights the effectiveness of minimal intervention. The resolution observed after 9 months supports the potential success of conservative management, reducing financial, psychosocial, and risk impacts on the family while ensuring the infant's well-being.