Abstract
Congenital granular cell epulis is a rare benign soft tissue lesion arising from the alveolar ridge in neonates. A rare case of multiple congenital granular cell epulis is reported, alongside a description of its vascular immunohistochemical profile. A female newborn presented with two exophytic pedunculated red nodules located on the alveolar ridge between the future eruption sites of the incisors and canines of the mandible and maxilla. A conservative surgical excision was performed on the second day of life. Histology revealed proliferation of round granular cells containing an abundant eosinophilic cytoplasm with basophilic nuclei, ranging from round to oval in shape. Numerous blood vessels were also seen. Immunohistochemical analysis of the granular cells revealed positivity for CD68, D2-40, Ki67, VEGF, and FGF and negativity for S100, CD34, and CD105. Immunostaining for CD34, CD105, and D2-40 confirmed the presence of a large number of blood and lymphatic vessels. Although rare, an understanding of this lesion is paramount for correct diagnosis and appropriate treatment. In the present report, the immunohistochemical profile confirmed increased vascularization, proving that these lesions are composed of not only new and preexisting blood vessels, but also lymphatic vessels.
Highlights
According to the most recent classification by the World Health Organization (WHO) [1], congenital granular cell epulis (CGCE), known as congenital granular cell tumor, congenital epulis, congenital epulis of the newborn, congenital granular cell lesion, and gingival granular cell tumor of the newborn [2, 3], is a rare benign soft tissue lesion, which usually arises from the alveolar ridges of neonates
CGCE is a sessile or pedunculated nodule, which is usually attached to the alveolar ridge of neonates, and rare, the presence of multiple lesions is rarer still, having been reported in approximately 10% of cases [2]
CGCE consists of large round granular cells with an abundant eosinophilic cytoplasm and basophilic nuclei set in a prominent vasculature
Summary
According to the most recent classification by the World Health Organization (WHO) [1], congenital granular cell epulis (CGCE), known as congenital granular cell tumor, congenital epulis, congenital epulis of the newborn, congenital granular cell lesion, and gingival granular cell tumor of the newborn [2, 3], is a rare benign soft tissue lesion, which usually arises from the alveolar ridges of neonates. CGCE is a sessile or pedunculated nodule, which is usually attached to the alveolar ridge of neonates, and rare, the presence of multiple lesions is rarer still, having been reported in approximately 10% of cases [2]. These lesions present as normal or red in color and vary in size, from several millimeters to a few centimeters. The present report describes the clinical, histopathological, and immunohistochemical profile of a case of multiple CGCE
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