Oral cavity & oropharynx
Soft tissue, neural & uncertain origin tumors
Congenital granular cell epulis

Topic Completed: 1 January 2013

Minor changes: 13 October 2020

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PubMed Search: Epulis[TI] oral cavity[mh]

Charu Thakral, M.D.
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Cite this page: Thakral C. Congenital granular cell epulis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/oralcavityepulis.html. Accessed March 8th, 2021.
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

Contributed by Dhiraj B. Nikumbh, M.B.B.S., M.D.

2 day old girl with
difficulty eating and
breathing due to
upper jaw lesion

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Lesion at 3 weeks

Lesion at 16 months

Tumor arising from anterior maxillary alveolus

Mass protruding from mouth

Gross images

Contributed by Dhiraj B. Nikumbh, M.B.B.S., M.D.

Congenital granular cell tumor

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

Contributed by Dhiraj B. Nikumbh, M.B.B.S., M.D.

Stratified squamous epithelium

Abundant granular eosinophilic cytoplasm


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Polygonal cells with granular cytoplasm and small round nuclei

Meshwork of delicate blood vessels

Positive stains
Negative stains
Electron microscopy images

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Granules and lysosomes

Differential diagnosis
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