Answer:
D) Present from birth
Step-by-step explanation:
One way we can infer the meaning of the adjective "congenital" is by using context clues, that is to say, by looking at the surrounding information of that unknown word that gives us clues of what "congenital" means. In the text, there are two context clues: "not a new growth", and " It had remained unchanged from the day Saul was born", which suggests that the work on Saul's neck has been there since he was born.