Radio Cadena Agramonte
Wednesday, December 13, 2017
Wednesday, February 11, 2009

Congenital epulis, from fright to cure



Text and photos: Gualveris Rosales Sánchez

uncommon malformation located in the upper jawAfter 40 weeks of pregnancy and having attended the doctor’s appointments and undergone all the medical tests, even the ultrasound tests which are free in Cuba as part of the Protection Programs for Pregnant Women, Yamilka Martínez Castillo began to feel the classic labor pains.

Her first daughter was about to be born; the also young father, Julio César Gregorí Fernández, was so anxious that he could not be silent nor calm.
But a discovery threatened to muddle their happiness.

A very uncommon event happened, something that the medical staff at Camagüey-based Infant Maternal Provincial Hospital “Ana Betancourt de Mora” have not even imagined, the little baby, of about 3 000 grams of weight, had such a buccal protuberance that was both unpredicted and impressive.

Mother and surgeons were in presence of a malformation that science had described for the first time in 1871, but since then only in less than 200 occasions it has been reported in the whole world, this malformation is known as Congenital epulis.

First hours of anguish

In general, the delivery occurred without any kind of complications and the baby presented a good clinical condition, but due to this anomaly she was taken immediately to the Intensive Care Unit of the hospital, where the Group of Neonatology took charge of the case.

The little baby girl had an irregular and movable tumor of about four centimeters of diameter. That tumor hanged from the superior jaw and seemed to go out of her mouth like a pink and lustrous ball, so the mother could not feed her in the natural way.

For the group of doctors and nurses this new case was not one of the most complicated, but was one of the rarest.

The interesting thing is that the hospital had not registered a malformation of this kind for at least 15 years.

Although big, the tumor did not obstructed the airways, so the infant could breathe without ventilator. Nevertheless they had to feed her through a orogastric tube.
 
Surgical intervention

The little Roxana de la Caridad went on her way to the cure. Another staff of doctors, this time in the Pediatric Hospital of Camagüey, put their expert hands on her. The operation hardly lasted one hour, they used general anesthesia and had to assist her smooth lungs with a respirator.

The fact that the protuberance had a narrow base, typical of these lesions, facilitated the work of the maxillofacial specialists.

Dr. Orlando Ojeda Díaz, First Degree Specialist in Neonatology of the Hospital “Ana Betancourt de Mora” assists little Roxana de la CaridadThe tissues were completely removed and they took samples for the histological analysis of the case. What they found there corroborated the suspicions Dr. Orlando Ojeda Díaz, First Degree Specialist in Neonatology of the Hospital “Ana Betancourt de Mora” had since the very beginnings.

A case of Congenital epulis had been revealed in the city of Camagüey, Cuba, on April 20th, 2004.

The surprise does not end yet

One month later, I visited Roxana de la Caridad in her home at “José Martí” neighbourhood and met a nine pound beautiful baby with vivacious eyes and a voracious appetite.

It is ought to say that that impression was diametrically opposed to the first we had.

The mom and the paternal grandmother told me of how uncertain and bad were those days in April for the whole family, especially for Julio César and Yamilka. But something was saved for the last. Two teeth sprouted from Roxana’s gum. And they were big!

Under the benign outgrowth of scaly tissue that, according to doctor Orlando Ojeda’s, after its extirpation does not reproduce itself.

Roxana developed two well formed incisives, which were not removed during the surgical procedure, and remained as temporary natural teeth.

The baby lost one of them when rubbed her gum with the hand, while the other one still is on her mouth caressing the breast that warms and feeds her.

A promissory future awaits Roxana in her Island nation, where the medical attention is totally free and there is not discrimination. When she grows up she will also be able to access a high level education system and become a professional, in the career she prefers.

Maybe she will choose to be a doctor or a nurse and then she will have in her hands the immense power of healing and providing happiness to others.