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Oral Granular Cell Tumors Clinical Presentation

  • Author: Steven Brett Sloan, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: Feb 19, 2016


Granular cell tumors are slow-growing lesions (0.5-1 mm per year) that are neither painful nor tender. Congenital epulis apparently is neither painful nor tender. The rate of growth is difficult to determine because of its presence at birth and the need for its removal to allow feeding. No etiologic factors appear to be associated with either lesion. Note the image below.

Clinical photograph of a granular cell tumor on thClinical photograph of a granular cell tumor on the tongue of a 38-year-old man.


Granular cell tumors usually are painless and appear as slightly yellowish swelling just beneath the surface epithelium. These lesions are firm and nontender on palpation and generally less than 2 cm in diameter. Ulceration of the surface epithelium is uncommon. Salivary gland obstruction by lesions on the floor of the mouth can cause pain. Displacement of the glossopharyngeal nerve and subsequent irritation from impingement against the styloid process can lead to pain with swallowing, turning the head, or extending the tongue (Eagle syndrome).[5]

The head and neck region accounts for approximately 45-65% of all sites for granular cell tumors. Approximately 70% of oral granular cell tumors occur in the tongue.[6, 7] Buccal mucosa accounts for about 10-15% of oral lesions. Approximately 10% of lesions have been reported bilaterally. Multiple tumors are occasionally present.[8, 9, 10]

Congenital epulis occurs more frequently in the maxilla. These lesions generally are less than 2 cm in diameter. Large lesions can interfere with breathing and feeding.[11, 12]



The etiology of the granular cell tumor and congenital epulis is unknown.

Contributor Information and Disclosures

Steven Brett Sloan, MD Associate Professor, Department of Dermatology, University of Connecticut School of Medicine; Residency Site Director, Connecticut Veterans Affairs Healthcare System; Assistant Clinical Professor, Yale University School of Medicine

Steven Brett Sloan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Connecticut State Medical Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Journal of the American Academy of Dermatology;Up to Date;Medical Review Institute of America.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, American Dental Association

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

James W Patterson, MD Professor of Pathology and Dermatology, Director of Dermatopathology, University of Virginia Medical Center

James W Patterson, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Society of Dermatopathology, Royal Society of Medicine, Society for Investigative Dermatology, United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.


Robert Howell, DDS, MSD Professor, Department of Diagnostic Sciences, West Virginia University School of Dentistry

Disclosure: Nothing to disclose.

Melinda Jen, MD Department of Pediatrics, Section of Pediatric Dermatology, Children's Hospital of Philadelphia

Melinda Jen, MD, is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

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Clinical photograph of a granular cell tumor on the tongue of a 38-year-old man.
Granular cell tumor.
Congenital epulis.
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