P15.11: Severe fetal head moulding without labor

Abstract

The congenital epulis is a rare benign tumor of the oral cavity, which develops in the later stages of pregnancy, mainly among female fetuses. The prenatal diagnosis of congenital epulis is important because large tumors can cause oral and airways obstruction during both the prenatal and newborn period. We reported two cases of congenital epulis identified as intraoral masses by prenatal ultrasonography. One case was diagnosed by ultrasonography at 35 weeks gestation. The size of mass was 2.1 × 2.1 cm. The mass appeared well circumscribed, homogeneous, hypoechoic and originated from the alveolar tissue of maxilla and no other abnormalities were seen. Prenatal MRI showed that the mass did not induce any airway obstruction. The female infant was delivered at 37 weeks gestation with good condition and did not require airway intubation. The mass, which a 3.0 × 2.5 cm solid mass developing from the mid-maxillary alveolus was surgically removed on 2 days after birth. The pathologic examination of tumor revealed a congenital epulis. Feeding was started on 2 days after excision. The baby is healthy and has still no recurrence during 20 months follow up. In another case, the intraoral mass was diagnosed by prenatal ultrasonography at 33 weeks gestation. The characteristics of tumor was same as case 1 and the size of mass was 3.9 × 2.9 cm. No other abnormalities were seen. The fetus was not born yet. Congenital epulis can become life-threatening for the newborn because of the risk of respiratory obstruction. Therefore it is important for the parents to receive prenatal counseling with accurate diagnosis of the fetal oral tumor.