Imaging Characteristics and Differential Diagnosis of Newborn Oral Tumors Based on a Prenatally Diagnosed Neumann Tumor

The spectrum of congenital lesions in newborns includes various soft and hard tissue masses found within or near the oral cavity. While oral clefts are often easily diagnosed prenatally and treated after birth, other critical conditions may require immediate neonatal intervention. These include airway compromise resulting from choanal atresia, alveolar mucosal fusion, or space-occupying lesions that reduce airway volume. Furthermore, some lesions may cause significant bleeding or interfere with sucking and feeding. In such cases, careful prenatal evaluation using ultrasound (USG) and magnetic resonance (MR) imaging is essential to inform the timing and strategy of surgical interventions. The occurrence of a rare lesion, such as a congenital epulis, also known as a Neumann tumor (NT), requires precise diagnostics to exclude other worrisome pathologies. Detailed MR evaluation of the oral commissure, tongue, lips, and gingival area helps identify the lesion’s extent and its anatomical relationship with adjacent structures. Although serial ultrasonography demonstrated interval growth, near-term MRI showed no pharyngeal extension or laryngotracheal narrowing. An EXIT-to-airway procedure was not planned, and delivery was performed by elective cesarean section with multidisciplinary airway support available. This report highlights that local NT removal typically focuses on complete excision, evaluation of the tumor base, and assessment of the surrounding alveolar bone.