Granular cell tumor: a great masquerader

Granular cell tumor usually presents as an asymptomatic mass in the skin or subcutaneous tissue, yet it is rarely considered in the clinician's differential diagnosis of such masses. We present a case of granular cell tumor located on an extremity and discuss its characteristic histopathologic findings and aspects of its origin and management.     

Granular cell tumor of the suprasternal space

A case of granular cell tumor (GCT) was reported. We encountered a 33‐year‐old woman with a painless, elastic, hard mass in the soft tissue of the suprasternal space. The tumor was excised with several millimeters margin of normal tissue above the deep cervical fascia and the wound was closed primarily. Histological examination on hematoxylin–eosin stain showed a tumor growth in the mid‐ to deep dermis and eosinophilic small granules that were consistent with granular cell tumors. Immunohistochemical studies showed positive staining for S‐100 protein. We experienced a case of a granular cell tumor occurring in the suprasternal space and report the importance of including it in the differential diagnosis of subcutaneous soft tissue tumors.     

Granular cell tumor (Abrikossoff tumor) of the clitoris

A 60-year-old woman presented to the Department of Dermatology of the ABC Medical Center in Mexico City with a 2-month history of a progressive growth in the region of the clitoris that had been increasing rapidly. Examination revealed a firm growth measuring 3 cm in diameter; the overlying surface was smooth and free of ulceration. Vaginal speculum examination showed no mucosal irregularities or displacement. Rectal examination was normal. Inguinal lymph nodes were clinically negative. A wide excisional biopsy was performed with ample skin margins.
The specimen consisted of a mass measuring 3.5 × 1.2 × 0.5 cm that was pale tan, homogeneous, and firm. Prepared sections showed a cellular tumor composed of compact irregular strands and nodules of polyhedral cells containing centrally located, round to oval vesicular nuclei with no significant atypia of mitosis. These cells had granular eosinophilic cytoplasm with distinct cell borders (Fig. 1). The cytoplasmic granules were diastase-resistant periodic acid-Schiff (PAS) positive. The tumor cells were positive for S–100 protein and for neuron-specific enolase (NSE), and were negative for actin, desmin, and cytokeratin. The tumor showed compression and obliteration of the cavernous sinuses (Fig. 2) outlined by the S–100 immunostain and actin. (Figs 3 and 4).     

外阴颗粒细胞瘤一例

患者,女,23岁.左侧大阴唇结节1年.组织病理示:真皮内圆形、多角形细胞浸润,浸润细胞内含丰富的细颗粒性胞质和中央小的圆形胞核,可见较大的嗜伊红小体.免疫组织化学检查示:肿瘤细胞S100(+),NSE(+),CD68(弱阳性),CK(-),Ki-67<1％.综上诊断为(外阴)颗粒细胞瘤.予病损切除术,术后随访3个月未见...     

Granular cell tumor on the palm of an 8-year-old girl

Granular cell tumors are rare benign peripheral nerve neoplasms that are most commonly reported on the tongue and oral mucosa. Rarely, they can present as masses on the extremities. They are often treated surgically, however, guidelines for the optimal surgical management of these lesions have yet to be defined. We report a child with a granular cell tumor of the palm that required removal by an orthopedic hand surgeon.     

Granular cell tumour

A 5?-years-old boy presented with multiple skin coloured subcutaneous nodules on scrotum and penoscrotal regions. Oldest lesion started 8 months back and new lesion was one month old. Biopsy report revealed the tumour to be granular cell tumour.     

Granular cell tumor of the scrotum in a child with Noonan syndrome

Abstract:  Granular cell tumor is a rare neoplasm thought to be of neural origin, composed of cells with distinctive granular cytoplasm. Granular cell tumors most often arise on the tongue, but can occur at any body site, and therefore initial presentation to dermatologists is common. We report a granular cell tumor of the scrotum in a child with Noonan syndrome, known to have a mutation in the PTPN11 gene. No previous reports of granular cell tumor of the scrotum in a child are found. The tumor is usually benign; however, it can have a high local recurrence rate (variable between 2% and 50% dependent on whether initial excision is complete and on the occurrence of an infiltrative growth pattern) and therefore long-term follow-up is necessary. This case highlights the occurrence of granular cell tumor, a diagnosis not to be missed by the dermatologist. In addition, we postulate the possible role of PTPN11 mutations in the development of granular cell tumor.     

Granular cell basal cell carcinoma

Granular cell basal cell carcinoma (BCC) is a rare histologic variant of BCC. In this, the third reported case, the tumor consisted almost entirely of granular cells. By electron microscopy, these cells were filled with pleomorphic lysosome-like granules lined by unit membranes and containing homogeneous or granular electron-dense bodies, membranous debris and amorphous material. The epithelial origin of the tumor was suggested by the characteristic light microscopic appearance of tumor cell islands with some areas of peripheral palisading, and was confirmed by electron microscopic features of numerous well-formed pentalaminate desmosome junctions and sparse cytoplasmic tonofilament bundles, some of which showed attachments to the desmosomes. Histochemical immunoperoxidase stains for lysozyme showed no cytoplasmic lysozyme activity, in common with other granular cell tumors, but ultrastructural examination did not reveal angulate bodies, in contrast to findings in non-epithelial granular cell tumors.     

Granular cell basal cell carcinoma

A 69-year-old woman presented with a 2-year history of a slowly growing tumour on the nose. The clinical diagnosis was basal cell carcinoma (BCC) and a complete excision was performed. Histologically, the tumour had the general features of a BCC but with sheets and nests of cells with granular cytoplasmic changes in the centre of the lesion. A pathological diagnosis of granular cell BCC was made. On immunohistochemical examination, the tumour cells were Ber-EP4, cytokeratin AE1/AE3 and cytokeratin CAM 5.2 positive but S100 protein negative. Only the granular cells were CD68 antigen (monoclonal antibody KP1) positive.     

Granular cell tumor on the sole of a child: a case report

Granular cell tumor, also known as Abrikossoff tumor, is a rare infrequent neoplasm of unclear etiology which has been rarely described in children. Involvement of the feet is extremely rare. We report a 7-year-old boy presenting a granular cell tumor on the sole.     

Granular cell atypical fibroxanthoma

We report on two patients with granular cell atypical fibroxanthoma. Both neoplasms were solitary, light-tan, dome-shaped papules on sun-exposed areas of the head in two elderly white men. Microscopically, these neoplasms showed a dermal proliferation of pleomorphic granular cells with irregular hyperchromatic nuclei, multinucleated cells, and scattered mitoses. Immunohistochemical stains were positive for CD68 and vimentin and negative for Melan-A or human melanoma black (HMB)-45, S-100 protein, pancytokeratin, and actin, consistent with atypical fibroxanthoma. The differential diagnosis of granular cells in neoplasms containing cytological pleomorphism is challenging in view of the many different neoplasms that may present with granular cytoplasm. These include the conventional granular cell tumor and its malignant form, leiomyoma, leiomyosarcoma, dermatofibroma, dermatofibrosarcoma protuberans, and angiosarcoma.     

Granular cell tumor. An analysis of 16 cases and review of the literature

Sixteen patients with granular cell tumors were seen between 1964 and 1979. The medical data of these patients showed an average age incidence of 39 years and a greater frequency among Negroes (69%) and in female patients (62.5%). The most common sign (in 12 of 16 patients) was the presence of an asymptomatic mass. There was a total of 88 tumors in 16 patients; 74 arose in the skin, 6 in the oral cavity, 2 each in the breast and perineum, and 1 each in the larynx, parotid gland, eyelid, and appendix. Multiple tumors were noted in 4 patients (25%), all of whom were Negroes. The histogenesis of this tumor is still controversial but appears to favor the theory of multipotential undifferentiated mesenchymal cell origin.