Oral cavity
Congenital anomalies

Author: Charu Thakral, M.D. (see Authors page)

Revised: 7 February 2017, last major update January 2013

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: epulis oral cavity
Cite this page: Epulis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/oralcavityepulis.html. Accessed February 24th, 2018.
Definition / general
  • Congenital granular cell tumor of alveolar mucosa of jaw in newborns
  • 90% girls; 10% present as multiple lesions
  • Doesn’t recur, even if incompletely excised
  • 0.5 - 2 cm soft, pedunculated mucosal mass
  • Spontaneously regresses over first 8 months of life (Am J Surg Pathol 1981;5:37)
  • Congenital granular cell myoblastoma, granular cell epulis of infancy and granular cell fibroblastoma
  • Exclusively on anterior alveolar ridge of maxilla and mandible, usually overlying future canine and lateral incisor teeth
Case reports
Clinical images

Images hosted on PathOut server:

2 day old girl with difficulty eating
and breathing due to upper jaw lesion,
contributed by Dr. Dhiraj B. Nikumbh

Images hosted on other servers:

Lesion at 3 weeks

Lesion at 16 months

Tumor arising from anterior maxillary alveolus

Mass protruding from mouth

Gross images

Images hosted on PathOut server:

Congenital granular
cell tumor, contributed
by Dr. Dhiraj B. Nikumbh

Images hosted on other servers:

Homogenous appearance

Microscopic (histologic) description
  • Confluent to nodular submucosal growth of tumors composed of large polygonal cells with eosinophilic granular cytoplasm and small central nuclei
  • Overlying epithelium is atrophic; does NOT show pseudoepitheliomatous hyperplasia (common with granular cell tumor of adults)
Microscopic (histologic) images

Images hosted on PathOut server:

Contributed by Dr. Dhiraj B. Nikumbh:

Tissue bits lined by
stratified squamous
tumor is beneath

Tumor composed of cells having abundant
granular eosinophilic cytoplasm
with monomorphic vesicular nuclei
with inconspicuous nucleoli


Images hosted on other servers:

Polygonal cells with granular cytoplasm and small round nuclei

Meshwork of delicate blood vessels

Positive stains
Negative stains
Electron microscopy images

Images hosted on other servers:

Granules and lysosomes

Differential diagnosis