Epulis K06.80

Generic term for aetiologically non-uniform, tumour-like (pseudotumour), non-specific, inflammatory and irritant granulation or resorption tumours which occur solitary or multiple times in the area of the gingiva or alveolar mucosa.

The following classification is possible:

• Epulis gravidarum
• Giant cell pulis (syn: peripheral giant cell granuloma)
• Epulis fibrosa.

Probably caused by chronic irritation of the gums (prosthesis, tooth filling); also congenital. More frequent occurrence during pregnancy (epulis gravidarum or pregnancy tumour). The so-called giant cell pulposus already occurs from the age of 6 years on, during the change of teeth. In epulis fibrosa, fibrosis leads to the formation of a hard, reddish tumour, usually on the vestibular side of the gingiva.

Mostly alveolar ridge; gingiva.

Pea- to cherry-sized, bright red, centrally occasionally eroded or ulcerated, slightly bleeding polyposis; depending on the extent, diastema and secondary malocclusion; no significant pain.

Mostly unspecific (inflammation-like) granulation tumour. It contains many giant cells of the osteoclast type and is therefore also called Epulis gigantocelullaris.

Benign or malignant tumours; fibroids; fistulas; pulp polyps.

Excision and histological control. Cooperation with the dentist.

The giant cell pulposus of the gums behaves more like a real tumour. It does not regress spontaneously and tends to recur.

Pseudotumors with a similar structure are found on the tendon sheaths and on the inner skin of the joints. They are referred to here as "giant cell-containing tendon sheath tumor or villonodular synovialtitis".

1. Grundmann (2018) Dignity of tumors. Short textbook pathology p. 205 Elsevier Munich

2. Truschnegg A et al.(2016) Nonsurgical treatment of an epulis by photodynamic therapy. Photodiagnosis Photodyn Ther 14:1-3.