congenital oral granular cell myoblastoma
A congenital granular cell myoblastoma (also known as congenital epulis) is a very rare benign tumor which classically presents in the fetal-neonatal population.
Epidemiology
It occurs almost exclusively in females when it presents in the fetal-neonatal population although no such predilection occur when it rarely presents in older children.
Pathology
It is thought to occur as a result of excessive estrogen production from the fetal ovaries under HCG stimulation.
The histogenesis is uncertain, and proposed cells of origin include odontogenic epithelium, undifferentiated mesenchymal cells, pericytes, fibroblasts, smooth muscle cells, nerve-related cells, and histiocytes.
Location
It most commonly occurs along the alveolar ridge of the maxilla although less commonly, it can also occur in relation to the mandible.
Radiographic features
Antenatal ultrasound
Rarely a congenital epulis may be detected on antenatal ultrasound as an intra-oral mass. Color and power Doppler ultrasound examination may show marked blood flow within the tumor .
Differential diagnosis
General considerations include
- epignathus
- oropharyngeal rhabdomyosarcoma