Congenital granular cell epulis (CGCE) in a female newborn– Case Report

Congenital granular cell epulis (CGCE) is an exceptionally rare benign soft tissue tumor of the neonatal oral cavity, that usually originates from the neonatal gingiva and can lead to difficulty in breathing and feeding upon birth. It has predominance for females with an 8:1 ratio in relation to males and is exclusively encountered in the oral cavity. We present a case of a full-term female neonate, born after a regularly monitored, uncomplicated pregnancy, in whom multiple papillomatous growths were identified in the oral cavity within the first hours of life. A larger papillomatous lesion measuring 2 cm was noted on the tongue, accompanied by several smaller nodules measuring 0.4–0.6 cm nearby, as well as an additional lesion on the mandibular alveolar ridge. The neonate was under medical supervision and exhibited no significant respiratory or feeding difficulties. Complete surgical excision was the treatment of choice and was performed under general anesthesia on the second day of life. The postoperative course was uneventful, with stable vital signs maintained throughout. Histopathological and immunohistochemical analyses confirmed the diagnosis of CGCE. Postoperatively, the infant was regularly followed by the neonatologist, with no recurrence of the lesions observed, satisfactory healing, and normal growth and development. This case highlights the unusual multifocal presentation of CGCE, including involvement of both the tongue and mandible, and emphasizes the importance of prompt recognition, surgical intervention, and histopathological confirmation to ensure optimal neonatal outcomes