Congenital epulis of the newborn: 2 cases report and a literature review

Abstract

Objective To investigate the clinical features, diagnosis and treatment of congenital epulis, to provide a reference for clinical diagnosis and treatment. Methods Two cases of congenital epulis in the mandible and maxilla of a newborn were reported, and the boundary and size of the tumor were determined by ultrasonography and MRI. The tumor was resected under general anesthesia. The previous literature on congenital epulis was reviewed and analyzed. Results Patient 1 (male) had a hard mass of approximately 20 mm × 15 mm × 10 mm in the right mandible immediately after birth. MRI was performed, and the mass was removed. In Patient 2 (female), a mass approximately 24 mm × 23 mm × 20 mm in the oral cavity of the anterior maxillary region was shown on ultrasound at 29 gestational weeks, and the mass grew rapidly in the last trimester. The mass was removed after birth. Postoperative pathological examination revealed congenital epulis. The results of the literature review showed that the incidence of congenital epulis is greater in females than in males, and it mainly occurs in the maxillary incisor area. Congenital epulis does not invade bone and does not affect tooth development. When a mass affects a child's breathing or swallowing, it must be surgically removed in a timely manner. Recent studies have shown that there is no evidence of recurrence after surgical resection. The histological origin and etiology of the disease are not clear. Clinically, it is often necessary to distinguish between teratomas and congenital epulis. Regarding the clinical manifestations, teratomas and congenital epulis are similar in appearance, and the main distinguishing point lies in pathological manifestations. Under the microscope, teratomas are observed as mature or immature tissue from various embryonic layers, while congenital epulis involves tightly arranged, homogeneous, polygonal to microspindle-shaped, medium to large cell compositions of nest-like and ribbon-like cells. Conclusion Congenital epulis is a rare oral tumor in neonates. The diagnosis should be based on the location, age, clinical manifestations, and imaging findings. The final diagnosis depends on pathological examination. When congenital epulis tumors affect children's breathing and eating, they should be surgically removed as soon as possible, and there is almost no recurrence after surgery.

Keywords

• congenital epulis|maxilla|mandible|diagnostic imaging|oral tumors|differential diagnosis|pathological diagnosis|histology and embryology|surgery