Diagnosis of Path Quiz Case-10 : Congenital Gingival Granular Cell Tumour (Congenital Epulis)

Case 10: Case history and images:

Congenital gingival granular cell tumours are rare benign tumours of uncertain histogenesis.

Site: Alveolar ridge of the maxilla in newborns . Sex: Striking predilection for female infants  suggests the presence of an endogenous hormonal stimulus in utero.

Microscopic features:  Image 1 ; Image2 ;  Image3 ;  Image4

 Like adult granular cell tumour  this lesion is composed of polygonal cells with abundant granular cytoplasm and small eccentric nuclei with occasional small nucleoli. There is a prominent vascular stroma with perivascular lymphocytes and histiocytes. Entrapped non-neoplastic odontogenic epithelium may be present in some cases. There is no pseudoepitheliomatous hyperplasia of the overlying squamous mucosa and no nerve bundles are seen within these lesions.

The tumour is negative when immunostained with S100 protein, in contrast to adult granular cell tumours.

Differential diagnosis: Teratoma, leiomyoma, congenital dermoid cyst,  congenital fibrosarcoma, and congenital lipoma.

Visit: Granular cell tumour ; Granular Cell Tumour of Bronchus ; Granular Cell tumour of Esophagus ; Paediatric Intra-Oral Tumours.