Congenital Granular Cell Epulis in a Newborn: Diagnostic and Surgical Challenges in a Resource-Limited Setting-A Case Report.

Congenital granular cell epulis (CGCE) is a rare benign tumor of the neonatal gingiva, with fewer than 250 cases reported worldwide. It presents most commonly as a pedunculated mass arising from the maxillary alveolar ridge and may interfere with feeding or, rarely, respiration. Early recognition is essential, particularly in resource-limited settings where diagnostic tools may be restricted. We report the case of a 7-day-old female neonate born at term with a 2 × 1.5 cm smooth, pedunculated intraoral mass originating from the anterior maxillary alveolar ridge. The lesion did not impair respiration or feeding. Baseline laboratory investigations were normal, and the mass was electively excised under general anesthesia on day 7 of life. Histopathology revealed large polygonal cells with granular eosinophilic cytoplasm and atrophic overlying epithelium, confirming the diagnosis of congenital granular cell epulis. Immunohistochemical studies were not available. Postoperative recovery was uneventful, with complete resolution and no recurrence at the one-month follow-up. CGCE can be effectively managed with simple surgical excision, even in low-resource environments. Increased awareness among clinicians is essential to ensure timely diagnosis and avoid unnecessary interventions.