Congenital Granular Cell Epulis: A Systematic Review of Cases from 2000-2017

Background: Congenital Granular Cell Epulis is a rare benign mesenchymal tumor that is usually present at birth as incidental finding, however, with the advances in the imaging technology, the prenatal diagnosis of the lesion is possible as early as at 26th weeks.

Objective: The aim of this review was to describe the overall pattern of occurrence and clinical presentation of CGCT, to determine if there are any risk factors associated with occurrence of CGCE, and determine the appropriate treatment time.

Methods: We searched electronic databases (Google Scholar, DOAJ, PubMed and Mendeley) to identify case reports of patients with congenital epulis from year 2000 through 2017. Criteria to accept the article included case reports and case series that had information about the patient’s sex and location of the tumor and a histological diagnosis.

Results: A total of 124 publications met inclusion criteria reporting on 156 cases. The region of Asia had majority of reported cases followed by Europe. Majority of the infants were born on term without any reported complication during pregnancy. The female to male ratio was 7.7:1.The maxilla to mandible ratio was 1.7: 1. In majority of the cases the lesion was solitary and predominantly occurred on the anterior aspect of the jaws. The most common complication due to the tumor was feeding difficulty. Majority of the cases were documented to have been managed surgically within a week postpartum.

Conclusion: Despite being a rare condition, whose diagnosis is suspected clinically but histopathological investigation is mandatory in the diagnostic process. Surgery can be done as early as few hours after birth, with no major post-operative complications.

Keywords: Congenital Granular Cell Epulis, Infant, maxilla, systematic review.