CONGENITAL GRANULAR CELL TUMOUR OF THE NEWBORN: A CASE REPORT OF THE RARE LESION

B.O. Castano¹, A.C. Oluwarotimi², O.A. Adesina³ and A.O.S. Ayodele4

  1. Department of Family Dentistry, General Hospital Mushin, Lagos.
  2. Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos.
  3. Department of Oral and Maxillofacial Surgery, Lagos State University Teaching Hospital, Ikeja
  4. Department of Oral and Maxillofacial Surgery, General Hospital, Lagos Island.

Abstract

Congenital granular cell tumour [CGCT], a benign soft tissue tumour was a surprise discovery to the parents as well as the obstretical staffs at birth. It developed in the maxillary left canine region causing oral disfigurement and feeding problems. Diagnosis was essentially clinical and confirmed by histology. Surgical excision was done. We describe a case of CGCT in a 3-week old female neonate in the paediatric dentistry unit of LASUTH.

Keywords: Congenital, Gingival granular cell, Maxilla, Neonate

Correspondence:

Dr. B.O. Castano
Department of Family Dentistry,
General Hospital,
Mushin,
Lagos
E-mail: babaalamu@gmail.com

Introduction

Congenital granular cell tumour [CGCT] is a rare benign soft tissue tumour found on the gingiva of the anterior dentoalveolar segment of the maxillary arch of the newborn.1-4 This tumour was first described in 1871 by a German pathologist, Dr Franz Ernst Christian Neumann and he called it congenital gingival epulis.1-4 The term ‘epulis’ is a Greek word meaning gingival swelling and in dentistry is a nonspecific hyperplastic gingival tissue or gingival mass.³ However, WHO recommended the terms congenital granular cell epulis; other terms used to describe this condition include: Congenital granular cell lesion, congenital epulis of the newborn, gingival granular cell tumour of the newborn, congenital granular cell myoblastoma and granular cell fibroblastoma.3 This lesion usually presents on the alveolar ridge as a smooth surfaced single pedunculated or sessile lesion of 2x2x1cm in dimension but may grow up to 9cm, disturbing respiration, feeding and cause inadequate mouth closure.3-5 It occurs more in females than males 10:1 and more in maxilla than mandible 3:1.3,5 The incidence of this tumour is 0.006% of newborns1, and the usual location is between the maxillary lateral incisor and canineu. Maternal hormone has been implicated in the development of this lesion, which grows rapidly in utero in the third trimester but may cease after birth. There are no associated dental abnormalities or congenital malformationu . Multiple lesions had been reported in 10% of CGCT cases.3-4

The histogenesis of this tumour is unknown, but postulated theories of aetiologic origins include: undifferentiated mesenchymal cells, Schwann cells, histiocytic, neurogenic, fibroblastic, myofibroblastic, endocrinologic, and odontogenic epithelial cellsu.5-6 The diagnosis is usually clinical but confirmed by histopathologic evaluation. Definitive treatment is surgical excision1-6, although there had been report of spontaneous regression.1,6 It rarely recurs even when incompletely excised.

We present this rare congenital gingival granular cell tumour in a three-week-old neonate.