Minimal intervention approach for a lesion suggestive of congenital granular cell epulis: a case report.
Letícia Maria Pereira Teixeira Fitpaldi, Dhara Schrok Monteiro Ataide, Franciny Querobim Ionta et al.
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Case in brief
A 3-month-old male infant was assessed for gingival swelling present since birth. Examination showed a reddish, multilobulated, sessile lesion on the anteroinferior alveolar ridge, with a smooth surface and gingiva-like consistency. Feeding and respiration were unaffected, and no systemic comorbidities were reported. The lesion was managed with clinical monitoring rather than excision. It had partially resolved by 6 months and completely resolved by 9 months, coinciding with eruption of the mandibular incisors.
What made this case unusual
The lesion was on the mandibular alveolar ridge in a male infant, whereas congenital granular cell epulis typically occurs in the maxillary anterior region and appears to favor females.
Diagnostic / clinical pearl
In an asymptomatic infant with a lesion suggestive of congenital granular cell epulis and no feeding or respiratory impairment, clinical monitoring may be considered; this lesion resolved without surgery.
Why it matters
The case illustrates that observation can avoid surgical intervention and its associated financial, psychosocial, and risk impacts for the family when the infant's well-being is maintained.