Oral Cavity Disorders Case

A 3.4-kg newborn girl presents with an oral lesion seen below.
Oral Cavity Disorders Case

There is a pedunculated, soft tissue mass attached to the alveolar ridge by a broad base.

What is the diagnosis?

A. Eruption hematoma

B. Ankyloglossia

C. Congenital epulis

D. Neonatal cyst

E. Fibroma

The correct answer is C. 

The infant has congenital epulis, which is rare, but more common in females than in males (8:1). It is a flesh-toned gingival granular cell tumor growing off the maxillary anterior alveolus. Treatment is excision of the lesion.

An eruption hematoma typically comes up on the gumline at that point where the crown of the tooth is about to break through; it is usually blue, because of the bleeding into the cysts. Ankyloglossia (tongue tie) is caused by a short and/or anteriorly displaced frenulum. A fibroma is a pedunculated or sessile growth that occurs secondary to irritation. The buccal mucosa and interdental gingiva are the most common sites (as opposed to the alveolus). Neonatal cysts are remnants of epithelia tissue (Epstein pearls) or mucus gland tissue (Bohn nodules). These cysts can be white, gray, or yellow in appearance. Surgery for neonatal cysts is not indicated, as spontaneous resolution is common. (Page 1357, Section 20: Disorders of the Oral Cavity, Chapter 378: Oral Pathology)


Question & Explanation and Photo: Cabana MD. Rudolph’s Pediatrics, 22e, Self-Assessment and Board Review; 2014.