Congenital epulis of the newborn: A comprehensive narrative review of epidemiology, prenatal imaging, histopathology, management, and outcomes

This comprehensive narrative review summarizes the available evidence regarding neonates with congenital epulis, the epidemiologic profile, prenatal imaging findings, histopathologic features, management strategies (surgical excision versus observation), and clinical outcomes. Congenital epulis is a rare benign gingival tumor of the newborn that can impair feeding and, occasionally, breathing. Because evidence is scattered across isolated case reports, clinicians lack clear guidance for counselling and perinatal management. A comprehensive literature search of MEDLINE, Embase, Scopus, and Web of Science was conducted from database inception to the final search date. Published case reports and case series involving neonates with congenital epulis were reviewed. Data regarding epidemiology, prenatal imaging, histopathology, management strategies, and outcomes were extracted and synthesized descriptively. One hundred twenty-four publications reporting 147 neonates were included. Most infants were female and had a solitary mass arising from the anterior maxillary alveolar ridge. Prenatal detection occurred in a minority of pregnancies. Early neonatal surgical excision was the predominant management, under general or local anesthesia, with minimal perioperative morbidity. No recurrences or malignant transformations were documented. Spontaneous regression was described only in a few small, conservatively managed lesions. Evidence, restricted to retrospective case reports, consistently indicates an excellent prognosis for congenital epulis. Simple early excision appears safe and curative for most lesions, whereas careful observation may be reasonable for selected small tumors. Further prospective, standardized reporting is needed to refine prenatal counselling and postnatal management.