Abstract

Introduction – Congenital Granular Cell Tumor (CGCT)is a rare benign tumour arising from the gingival mucosa. First described in 1871 by Neumann the tumor has marked female preponderance F:M ratio of 8:1, occurs rarely as multiple lesions only representing 10% of all cases. About 250 cases have been reported since 1871. The recommended treatment is surgical excision

Case presentation: Female neonate noted at birth with multiple pedunculated spherical masses with largest measuring diameter of 1.5cm  by 1cm and 2 smaller lesions attached to the incisor maxillary gingiva predominantly on the right posing difficulties  feeding and mouth closing, of note they was no upper airway obstruction nor dysmorphic features noted. Neonate was born by Caesarian Section at 40 weeks’ gestation by a 20-year-old mother who had unremarkable perinatal history. On ENT review a differential diagnosis of congenital abnormalities (anterior encephalocoele, Hemangioma, lymphangioma, digestive or tongue duplication), Benign congenital tumours(Congenital Epulis, Granular Cell Tumor, fibroma,rhabdomyoma) and malignant tumours(rhabdomyosarcoma, Schwannoma) were entertained and differentiation was sought by CT scan imaging to narrow the diagnosis.  Excision of Gingival masses was performed in OT with uneventful post-operative recovery. Subsequent review of histology showed features consistent with CGCT. Child is feeding well and teeth have erupted normally.

Conclusion and recommendation:   CGCT lesion usually rises over the incisor-canine region of the maxilla, maxillary: mandibular ratio of 3:1 and presentation is prompted by interference with respiration or feeding or for aesthetic reasons. Diagnosis often not easy when index of suspicion is low. Though worrisome to parents, can be satisfactorily managed by surgical excision and has a good prognosis.