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Herein, we detail a multidisciplinary approach and sequential treatment for two infants with congenital granular cell epulis (CGCE). Ultrasonic examinations at 34 weeks of gestation revealed prominent oral masses in both fetuses. To devise a carefully considered treatment strategy, a comprehensive multidisciplinary consultation including oral and maxillofacial surgeons, pediatricians, obstetricians, and anesthesiologists was convened. Following cesarean sections, the lesions were successfully removed, measuring approximately 30 × 15 mm and 30 × 20 mm in size, respectively. Immunohistochemical analysis showed that vimentin was positive, S-100 protein was negative, and NSE protein and CD68 protein were negative. These findings underscore the importance of prenatal diagnosis of congenital granular cell epulis for the effective management of these rare benign conditions.

Congenital granular cell epulis is a very rare tumor first described by Neumann in 1871. It is of mesenchymal origin with the female predilection in the ratio of 8:1. The lesion appears as a large protuberant mass and is commonly associated with obstruction causing difficulty in feeding and deglutition. We report a case of a newborn female who had feeding difficulty because of a protuberant mass arising from the oral cavity. The mass was surgically excised under general anesthesia and was histopathologically proven as congenital granular cell epulis. The follow-up for 3 months showed no recurrence. There are reported complications prenatally and postnatally. Hence, the treatment should be initiated early. The treatment of choice is complete surgical excision and no recurrence has been reported.

Congenital granular cell epulis (CGCE) is a rare benign lesion of the newborn. It was first described in 1871 by Neumann. The exact etiology of the condition still remains unknown. There is marked female preponderance 10:1. The lesion is usually solitary, but multiple lesions are seen in 10% of cases. They arise from the gingival mucosa of the maxillary or mandibular alveolar ridge. Depending on the size of the lesion it can be asymptomatic or can cause feeding or respiratory problems. Imaging studies can help in the prenatal diagnosis of the lesion as early as 26 weeks of pregnancy. Spontaneous regression can occur, but surgery is the treatment of choice in symptomatic patients. CGCE is important as it has to be differentiated from the other aggressive lesions of early life. We report a case of 1 day old female neonate with intraoral lesion. The histopathology of the excised specimen helped in the diagnosis.