Introduction: Congenital granular cell tumor (CGCT) is a rare, benign lesion that classically arises from the alveolar ridges in neonates. Extra-alveolar presentations, however, are exceedingly uncommon. Presentation of case: A term female infant (2840 g, born via cesarean section) presented with a prenatally identified 5 × 5 cm soft, pedunculated mass. It originated strictly from the lower gingival buccal sulcus, extending to the lower lip. Magnetic resonance imaging revealed an exophytic mass encasing the lower central incisor sockets. The mass was excised on day 3 of life. Histopathology showed polygonal cells separated by thin vascular and collagenous septa, confirming a CGCT. Feeding resumed on postoperative day two, and the infant remains well at 1-month follow-up. Clinical discussion: CGCT extending to the lower lip is atypical, often mimicking lesions like hemangiomas. Because these masses severely interfere with feeding and respiration, histopathological confirmation is essential for a definitive diagnosis. Conclusion: Complete en bloc surgical excision is recommended as the treatment of choice for CGCT. The risk of malignancy and recurrence remains extremely low.
Koirala et al. (Tue,) studied this question.