999 Case Report: A Rare Congenital Granular Cell Epulis In a Newborn Female Infant

Abstract Background A congenital granular cell epulis (CGCE) is a rare benign lesion of uncertain histologic origin that is found on the mucosa of the alveolar ridges of newborn babies. There have been less than 250 reported cases of CGCE. They are most commonly found in the anterior maxilla region in female infants. Case Report An 8-week-old female was referred from the Neonatal team with a 10mmX5mm lesion found at birth on the mucosa of the anterior maxilla. She was seen in the Oral and Maxillofacial Department where her parents reported that the lesion was causing discomfort when feeding and they were keen for its removal. On initial medical examination the patient was diagnosed with a Grade 1 ejection systolic murmur and was awaiting further cardiac investigations. With this in mind and the young age of the patient, it was decided an excisional biopsy of the lesion under local anaesthesia (LA) would be the safest option. The lesion was excised uneventfully when the patient was 9 weeks old. It was shown to be a congenital granular cell epulis following histopathological analysis. The patient was reviewed 8 weeks post-operatively. There were no signs of recurrence, the infant’s feeding had improved drastically, and she was thriving. Discussion CGCE is a rare and interesting lesion in neonates. Early diagnosis and treatment of CGCE is essential in facilitating infant feeding. This report highlights that a well-planned surgical excision under LA is a well-tolerated and safer option which is welcomed by parents.

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A case report and literature review: post-traumatic mammary myofibroblastoma

International Surgery Journal ◽

10.18203/2349-2902.isj20191283 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1385 ◽

Cited By ~ 1

Author(s):

Hadi Abdullah Alaskar ◽

Ahmed Mohammed AlMuhsin ◽

Mirza Faraz Saeed ◽

Amro Salem

Keyword(s):

Case Report ◽

Malignant Tumors ◽

Surgical Excision ◽

Excisional Biopsy ◽

Clinical Findings ◽

Histopathological Analysis ◽

Minor Trauma ◽

Elderly Age ◽

Rare Benign Tumor ◽

A Minor

Mammary myofibroblastoma is a rare benign tumor of the breast, with a higher incidence in elderly age group. It is diagnosed via radiologic and histologic findings, as clinical findings share the same presentation with other, more common, benign breast pathologies. Surgical excision is the only treatment modality used to treat this tumor. We report the case of a 56-years-old-male, who presented with the complaint of left-sided chest swelling for 1 year following a minor trauma to the chest. Ultrasonographic imaging of the mass was the initial investigation and it revealed a well-defined hypoechoic lesion, excisional biopsy was done, followed by histopathological analysis of the mass, which gave the diagnosis of mammary myofibroblastoma. The aim of this case-report is to further study and characterize this rare lesion and its relationship to previous minor or major trauma and other risk factors, in addition, a proper diagnosis should be taken when encountering a similar mass as it mimics many benign and malignant tumors, furthermore a follow up plan should be established to assess the rate of possible recurrence.

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Whitish-Yellow Tumor on its Characteristic Cut Surface: A Case Report of Congenital Granular Cell Epulis

Clinical Pathology ◽

10.1177/2632010x19831257 ◽

2019 ◽

Vol 12 ◽

pp. 2632010X1983125

Author(s):

Kenichi Mizutani ◽

Munenori Mukai ◽

Hitoshi Nagatsuka ◽

Sohsuke Yamada

Keyword(s):

Case Report ◽

Cross Section ◽

Benign Lesion ◽

Granular Cell ◽

Typical Case ◽

Case Presentation ◽

Granular Cytoplasm ◽

Congenital Granular Cell Epulis ◽

Cut Surface ◽

Multiple Nodules

Introduction: Congenital granular cell epulis is a rare and benign lesion in newborn. There are some papers of the entity; however, there are very few reports focusing on its macroscopic view. Case Presentation: A 0-day-old boy was noted to have a mass consisting of multiple nodules on maxillary gingiva, and it was excised. The mass was measured about 2 cm in its greatest diameter. Surface of cross-section was characteristically whitish-yellow and very smooth. Histopathologically, the lesion was composed of a proliferation of large polygonal cells with demarcated cell membrane, granular cytoplasm, and small uniform nuclei. Immunohistochemically, these cells were negative for S100. The diagnosis was concluded as congenital granular cell epulis. Discussion and Conclusion: We reported a typical case of congenital granular cell epulis. It is noteworthy that the cross-section observed in this case was very characteristically whitish-yellow and smooth.

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Congenital granular cell epulis: A case series

Journal of Neonatal Surgery ◽

10.47338/jns.v9.541 ◽

2020 ◽

Vol 9 ◽

pp. 17

Author(s):

Mustafa Okumuş ◽

Adil Umut Zubarioğlu ◽

Uğuray Payam Hacısalihoğlu

Keyword(s):

Benign Lesion ◽

Case Series ◽

Granular Cell ◽

Surgical Excision ◽

Postoperative Recovery ◽

Alveolar Ridge ◽

Congenital Granular Cell Epulis ◽

Malignant Lesions ◽

Rule Out

Background: Congenital granular cell epulis (CGCE) is an extremely rare intraoral tumor of the newborn with a potential to disrupt feeding and produce respiratory distress. Case Series: We report two newborns presented with mass protruding off the mouth since birth. The mass was arising from alveolar ridge in both cases and dealt with surgical excision. Histopathology revealed it congenital granular cell epulis. Postoperative recovery and follow-up are uneventful. Conclusion: Congenital granular cell epulis is a benign lesion though not quite uncommon, may cause diagnostic challenges. Early excision and histopathology rule out malignant lesions.

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Congenital granular cell epulis: a rare paediatric tumour of newborn

BMJ Case Reports ◽

10.1136/bcr-2021-244326 ◽

2022 ◽

Vol 15 (1) ◽

pp. e244326

Author(s):

Arun Mamachan Xavier ◽

Mahija Janardhanan ◽

Ravi Veeraraghavan ◽

Balagopal R Varma

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Granular Cell ◽

Histopathological Analysis ◽

Intravenous Sedation ◽

Alveolar Ridge ◽

Prompt Treatment ◽

Congenital Granular Cell Epulis ◽

Microscopic Findings

Congenital granular cell epulis is a congenital growth rarely found on the gingiva of neonates. These remarkably large tumours present in an infant’s mouth may impede with feeding, respiration or adequate mouth closure. Recognition of this entity and prompt treatment are essential for preventing any difficulties for the neonate. This is a case report of a 35-day-old female neonate who presented with a single exophytic lesion in the maxillary alveolar ridge. The differential diagnosis, management regimens and complications of this condition are reviewed. The lesion was excised under intravenous sedation and subjected to histopathological analysis. Based on the microscopic findings, the diagnosis of congenital granular cell epulis was confirmed. Clinicians including paediatricians, sonographers, dentists and surgical pathologists should be able to timely recognise and intervene such tumours as they may be potentially harmful to the infant.

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First Subungual Cryptococcosis Described in an HIV Patient with Disseminated Cryptococcosis

Skin Appendage Disorders ◽

10.1159/000516661 ◽

2021 ◽

pp. 1-3

Author(s):

Soumiya Chiheb ◽

Yasmine Slimani ◽

Rajaa Karam ◽

Farida Marnissi ◽

Fouzia Hali

Keyword(s):

Case Report ◽

Systemic Therapy ◽

Surgical Excision ◽

Excisional Biopsy ◽

Middle Finger ◽

Yeast Cells ◽

Histopathological Analysis ◽

Cryptococcal Infection ◽

The Right ◽

Cutaneous Cryptococcosis

Background: Cutaneous cryptococcosis occurs in 10–15% of patients with disseminated cryptococcosis. It typically presents as papulonodular molluscum-like lesions, but it can also produce a wide variety of lesions. Cryptococcal infection of the nail unit has never been reported. Case Report: A 28-year-old woman with a history of HIV with disseminated cryptococcosis in complete remission was referred to evaluate a subungual swelling of the right middle finger. Examination revealed an ulcero-burgeoning nodule over the right middle finger’s subungual area with onycholysis, eschar, and erosion. An excisional biopsy was performed. Histopathological analysis demonstrated multiple histiocytic granulomas centered by encapsulated yeast cells. Culture grew Cryptococcus neoformans var. neoformans. After 9 months of follow-up, there was no recurrence of the lesion. Discussion: It is the first reported case of nail involvement in the course of cutaneous cryptococcosis. Definitive diagnosis required pathology and culture. Cryptococcal infection of the nail unit was recalcitrant to systemic therapy while the remaining infection cleared. Our case report suggests that surgical excision associated with systemic therapy is the best treatment approach for subungual cryptococcosis. Recognition of rare manifestations of cutaneous cryptococcosis, such as ours, is essential because HIV cases increase continuously.

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Prenatal diagnosis and multidisciplinary management: a case report of congenital granular cell epulis and literature review

Journal of International Medical Research ◽

10.1177/03000605211053769 ◽

2021 ◽

Vol 49 (10) ◽

pp. 030006052110537

Author(s):

Yujiao Ye ◽

Ruiqi Tang ◽

Beibei Liu ◽

Yi Li ◽

Yunlu Mo ◽

...

Keyword(s):

Case Report ◽

Healthcare Professionals ◽

Histopathological Examination ◽

Granular Cell ◽

Team Approach ◽

Soft Tissue Lesion ◽

Fetal Ultrasonography ◽

Current Case ◽

Multidisciplinary Team Approach ◽

Congenital Granular Cell Epulis

Congenital granular cell epulis (CGCE) is a rare benign soft tissue lesion that usually originates from the neonatal gingiva and can lead to difficulty in breathing and feeding upon birth. This current case report describes a female newborn with a gingival mass that was identified by prenatal fetal ultrasonography. At birth, the oral mass was observed to protrude from the mouth, which adversely affected feeding. The lips could not be closed. The breathing was unaffected. Through a multidisciplinary team approach involving several healthcare professionals, the mass was successfully removed under general anaesthesia during an uncomplicated surgical procedure. Postoperative histopathological examination confirmed that the mass was a CGCE of the newborn. The infant recovered well after the operation.

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CD163+ Foamy Macrophages Are Associated with the Morphogenesis of Oral Verruciform Xanthoma through Angiogenesis by VEGF Expression: An Immunohistochemical Study

Dentistry Journal ◽

10.3390/dj8010018 ◽

2020 ◽

Vol 8 (1) ◽

pp. 18

Author(s):

Manabu Shigeoka ◽

Yu-ichiro Koma ◽

Takayuki Kodama ◽

Mari Nishio ◽

Masaya Akashi ◽

...

Keyword(s):

Macrophage Polarization ◽

Benign Lesion ◽

Surgical Excision ◽

Excisional Biopsy ◽

Vascular Endothelial ◽

Vegf Expression ◽

Verruciform Xanthoma ◽

Foamy Macrophages ◽

Endothelial Growth Factor ◽

Histological Architecture

Oral verruciform xanthoma (OVX) is an uncommon benign lesion that is characterized histologically by the accumulation of several foamy macrophages in the lamina propria papillae. The pathogenesis of OVX has not been completely elucidated, although the significance of macrophage polarization (M1, tumor suppression; and M2, tumor promotion) and the contribution of M2 macrophages to angiogenesis are well established. This study investigated the role of foamy macrophages in OVX, with a focus on angiogenesis. Four patients who underwent surgical excision or total excisional biopsy for OVXs were enrolled in this study. We evaluated the expression of the macrophage markers CD68 (broad) and CD163 (M2) and the CD34-positive microvessel density (MVD) of OVXs. The foamy macrophages of all patients exhibited positivity to CD68 and CD163. We evaluated the MVD and the expression of the vascular endothelial growth factor (VEGF) based on histological architecture. The MVD of all OVX cases was significantly higher than that of the corresponding normal epithelia. Interestingly, the MVD of verrucous-type OVX cases was higher than that of the other type. VEGF was expressed on foamy macrophages in all cases. Overall, the foamy macrophages expressing CD163 were associated with the morphogenesis of OVX through the process of angiogenesis by VEGF expression.

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