**Objectives** Congenital epulis (CE) is a rare benign tumour typically arising from the alveolar ridge and more frequently observed in female neonates. The report highlights its potential impact on neonatal breathing and feeding, emphasizing the importance of early recognition and management. **Case presentation** We present a case of a female neonate with a giant CE detected on prenatal ultrasound. After the birth the lesion interfered with feeding, while respiratory function remained unaffected. Three masses were surgically dissected from the maxillary mucosa and the neonate successfully transitioned to oral feeding within the first week. Histopathological examination revealed a granular cell tumour with negative immunoreactivity for S100. **Conclusions** The case underlines the significance of prenatal diagnosis, collaborative multidisciplinary planning, and, when indicated, the application of the EXIT procedure for congenital orofacial tumours with potential airway obstruction. Early recognition and integrated care can substantially improve neonatal prognosis.
Miškinaitė et al. (Mon,) studied this question.