Balasubramanian M.S. D.L.O.
“Epulis” is a
term meaning Gums. This term is used to denote a wide variety of
lesions involving the gums regardless of their pathology.
This is a
growth affecting the gingival mucosa of neonates. It is also known
as Neumann’s tumor. It is truly a benign condition affecting
predominantly female infants. It may even be multiple. This tumor
was first described in 1871 by Neumann and hence the name.
present at birth arising from the gingival mucosa of maxilla /
mandible. These infants may have feeding and breathing difficulties
because of the mass effect. Ultrasound studies have shown that this
tumor can arise as early as 26th
week of gestation.
commonly female neonates.
arises over the incision canine region of maxilla
also involve the gingiva over the mandible. Involvement of gingiva of
maxilla / mandible is 3:1.
lesions when large can interfere in breathing and feeding of the neonate
congenital Epulis resembles granular cell tumors. Its
differentiating features from granular cell tumors include:
arrangement of capillaries
shows no reactivity to S-100 protein and laminin.
also be borne in
mind that granular cell tumors involve almost all age groups and they
rarely affect gingiva. Granular cell tumors arise from Schwann cells
and hence positive for S-100 protein.
theory – Is the most accepted theory. He attributed development of
Epulis in neonates to reactive hyperplasia due to oestrogen changes.
This explains the female preponderance of the lesion.
If the lesion
is small and
asymptomatic it can be left alone. Spontaneous regression has been
documented. If the mass is large and symptomatic surgical excision
can be resorted to. After resection it is not known to recur.
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