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Yan J. Granular cell tumor of the breast: A case report and review of literature. World J Clin Cases 2023; 11:8044-8049. [DOI: 10.12998/wjcc.v11.i33.8044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/26/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Granular cell tumor (GCT) of the breast (GCTB) is a rare neoplasm that can exhibit malignant characteristics both clinically and radiologically. This tumor can also coexist and colocalize with breast carcinoma.
CASE SUMMARY We present a patient with this uncommon tumor and discuss the diagnostic and therapeutic approaches in order to further the knowledge of GCTB and prevent misdiagnosis and overtreatment. The characteristics of the tumor, methods of diagnosis, therapy and postoperative pathological outcomes were analyzed, and relevant literatures of GCTs were reviewed. The patient underwent surgery after core needle biopsy, and the excised neoplasm was sent for pathological examination. Histological analysis revealed nests of cells with abundant pink granular cytoplasm, confirming the diagnosis of GCTB.
CONCLUSION As manifestations of GCT and malignancy can mimic each other, a careful histological examination is essential before major surgery. Treatment consisting of complete excision with close clinical follow-up is recommended.
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Affiliation(s)
- Jun Yan
- Department of Breast Surgery, The University of Hong Kong - Shenzhen Hospital, Shenzhen 518000, Guangdong Province, China
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Meani F, Di Lascio S, Wandschneider W, Montagna G, Vitale V, Zehbe S, Harder Y, Parvex SL, Spina P, Canonica C, Generali D, Pagani O. Granular cell tumor of the breast: a multidisciplinary challenge. Crit Rev Oncol Hematol 2019; 144:102828. [PMID: 31710955 DOI: 10.1016/j.critrevonc.2019.102828] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 06/12/2019] [Accepted: 10/25/2019] [Indexed: 01/12/2023] Open
Abstract
Granular cell tumors are rare soft tissue tumors; they are almost never malignant, but can mimic a carcinoma clinically, radiologically and microscopically. The finding of a suspicious lump often entails subsequent diagnostic procedures that can pose significant anxiety on patients before reaching a challenging differential diagnosis. The physical and psychological burden is even more significant when such findings occur during the follow up of a previous oncologic condition. Sometimes the fear for a potential local or distant recurrence can be responsible for a misdiagnosis and lead to patient overtreatment.
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Affiliation(s)
- Francesco Meani
- Centro di Senologia della Svizzera Italiana (CSSI), Deparment of Obstetrics and Gynecology, Ente Ospedaliero Cantonale (EOC), Ospedale Italiano di Lugano, Via Pietro Capelli 1, 6962, Viganello, Ticino, Switzerland.
| | - Simona Di Lascio
- Centro di Senologia della Svizzera Italiana (CSSI), Deparment of Medical Oncology, Istituto Oncologico della Svizzera Italiana (IOSI), Ospedale Italiano di Lugano, Via Pietro Capelli 1, 6962, Viganello, Ticino, Switzerland
| | - Wiebke Wandschneider
- Centro di Senologia della Svizzera Italiana (CSSI), Deparment of Obstetrics and Gynecology, Ente Ospedaliero Cantonale (EOC), Ospedale Italiano di Lugano, Via Pietro Capelli 1, 6962, Viganello, Ticino, Switzerland
| | - Giacomo Montagna
- Centro di Senologia della Svizzera Italiana (CSSI), Deparment of Obstetrics and Gynecology, Ente Ospedaliero Cantonale (EOC), Ospedale Italiano di Lugano, Via Pietro Capelli 1, 6962, Viganello, Ticino, Switzerland
| | - Valerio Vitale
- Centro di Senologia della Svizzera Italiana (CSSI), Deparment of Radiology, Ente Ospedaliero Cantonale (EOC), Ospedale Italiano di Lugano, Via Pietro Capelli 1, 6962, Viganello, Ticino, Switzerland
| | - Sabine Zehbe
- Centro di Senologia della Svizzera Italiana (CSSI), Deparment of Radiology, Ente Ospedaliero Cantonale (EOC), Ospedale San Giovanni, via Ospedale 12, 6500, Bellinona, Switzerland
| | - Yves Harder
- Centro di Senologia della Svizzera Italiana (CSSI), Deparment of Reconstuctive and Plastic Surgery, Ente Ospedaliero Cantonale (EOC), Ospedale Italiano di Lugano, Via Pietro Capelli 1, 6962, Viganello, Ticino, Switzerland
| | - Sandra Leoni Parvex
- Centro di Senologia della Svizzera Italiana (CSSI), Istituto di Patologia Cantonale, via Selva 24, 6600, Locarno, Ticino, Switzerland
| | - Paolo Spina
- Centro di Senologia della Svizzera Italiana (CSSI), Istituto di Patologia Cantonale, via Selva 24, 6600, Locarno, Ticino, Switzerland
| | - Claudia Canonica
- Centro di Senologia della Svizzera Italiana (CSSI), Deparment of Obstetrics and Gynecology, Ente Ospedaliero Cantonale (EOC), Ospedale Italiano di Lugano, Via Pietro Capelli 1, 6962, Viganello, Ticino, Switzerland
| | - Daniele Generali
- Department of Medical Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - Olivia Pagani
- Centro di Senologia della Svizzera Italiana (CSSI), Deparment of Medical Oncology, Istituto Oncologico della Svizzera Italiana (IOSI), Ospedale Italiano di Lugano, Via Pietro Capelli 1, 6962, Viganello, Ticino, Switzerland; Geneva University Hospitals, Geneva, Switzerland
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3
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Omar L, Pfeifer CM, Kulkarni S, Sharma P, Sengupta A, Kwon JK. Granular cell tumor in a premenstrual female breast. Clin Imaging 2018; 52:334-336. [DOI: 10.1016/j.clinimag.2018.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 08/15/2018] [Accepted: 09/04/2018] [Indexed: 11/29/2022]
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[Rare benign breast tumors including Abrikossoff tumor (granular cell tumor), erosive adenomatosis of the nipple, cytosteatonecrosis, fibromatosis (desmoid tumor), galactocele, hamartoma, hemangioma, lipoma, juvenile papillomatosis, pseudoangiomatous hyperplasia, and syringomatous adenoma: Guidelines for clinical practice]. ACTA ACUST UNITED AC 2015; 44:1030-48. [PMID: 26530177 DOI: 10.1016/j.jgyn.2015.09.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 09/18/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To provide guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF), based on the best evidence available, concerning rare benign breast tumors: Abrikossoff (granular cell tumor), erosive adenomatosis of the nipple, cytosteatonecrosis, fibromatosis (desmoid tumor), galactocele, hamartoma, hemangioma, lipoma, juvenile papillomatosis, pseudoangiomatous hyperplasia, and syringomatous adenoma. METHODS Bibliographical search in French and English languages by consultation of Pubmed, Cochrane and international databases. RESULTS For erosive adenomatosis of the nipple, surgical excision is recommended to exclude Paget's disease or cancer (grade C). When surgery is performed for breast desmoid tumor or syringomatous adenoma, free margins are recommended (grade C). Without clinico-radio-histologic discordance, surgical abstention may be proposed for Abrikossoff tumor (granular cell tumor), cytosteatonecrosis, galactocele, hamartoma, hemangioma, lipoma, juvenile papillomatosis, pseudoangiomatous hyperplasia, and syringomatous adenoma (grade C).
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Aoyama K, Kamio T, Hirano A, Seshimo A, Kameoka S. Granular cell tumors: a report of six cases. World J Surg Oncol 2012; 10:204. [PMID: 23021251 PMCID: PMC3502223 DOI: 10.1186/1477-7819-10-204] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 09/10/2012] [Indexed: 12/27/2022] Open
Abstract
Granular cell tumor is a soft tissue neoplasm that originates in the nervous system and arises at virtually any body site, but is mainly found in the skin, oral cavity or digestive tract. Most are benign and reportedly malignant cases are rare, occurring in only 1% or 2% of cases. We report on our findings in six patients who developed granular cell tumor in the mammary gland, esophagus, subcutaneous tissue and muscle. Of six patients, two had granular cell tumor located in the breast, two in the submucosa of the esophagus, and the other two under the skin of the left axillary cavity and in the right latissimus dorsi muscle, respectively. One of the two patients with tumor in the submucosa of the esophagus also had esophageal cancer. Patients' age ranged from 41 to 70 years (average, 59.1 years). Two patients with tumor in the submucosa of the esophagus were men, and the others were women. All of them were given a diagnosis of granular cell tumor by tissue biopsy and examination of excised specimens, but no evidence of malignancy was found. No recurrence has been noted in the patients who underwent surgical tumor removal.
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Affiliation(s)
- Kei Aoyama
- Department of Surgery II, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
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Papalas JA, Wylie JD, Dash RC. Recurrence risk and margin status in granular cell tumors of the breast: a clinicopathologic study of 13 patients. Arch Pathol Lab Med 2011; 135:890-5. [PMID: 21732779 DOI: 10.5858/2010-0430-oar.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Granular cell tumors (GCTs) of the breast are rare neoplasms that mimic epithelial malignancy clinically and rarely occur in association with it. Granular cell tumors of the breast are not infrequently excised with positive margins. Reports describing risk of recurrence including data on margin status and follow-up are lacking. OBJECTIVE To review our series of GCTs of the breast to determine the risk of recurrence if excised with positive or close margins. DESIGN Cases of GCT of the breast were reviewed. Margin status of specimens was recorded as positive, close (<1 mm), and negative. RESULTS Thirteen female patients with GCT of the breast were identified. Mean patient age at presentation was 45 years. Seventy-seven percent of patients were African American and 23% were white. African American patients presented on average 13 years earlier than white patients. Average tumor size was 1.22 cm. Fifteen percent of lesions had positive margins on excisional biopsy or lumpectomy and 31% had tumor cells within 1 mm of the margin. One of 13 patients (8%) had coexistent invasive ductal carcinoma. Average follow-up for the entire group was 77 months. Patients with positive margins remained free of tumor progression or recurrence for 89 months and patients with close margins also remained disease free during a 64-month follow-up period. No tumors recurred out of the entire group. CONCLUSION Granular cell tumors of the breast have little long-term risk for recurrence, even when excised with positive margins. Surgical evaluation after nonexcisional biopsy may still be indicated to assess for the possible association of colocalized carcinoma.
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Affiliation(s)
- John A Papalas
- Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710, USA.
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7
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Granular cell tumor of the male breast. Updates Surg 2011; 63:139-42. [DOI: 10.1007/s13304-011-0051-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 01/27/2011] [Indexed: 12/11/2022]
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8
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Brown AC, Audisio RA, Regitnig P. Granular cell tumour of the breast. Surg Oncol 2010; 20:97-105. [PMID: 20074934 DOI: 10.1016/j.suronc.2009.12.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2009] [Revised: 10/24/2009] [Accepted: 12/02/2009] [Indexed: 11/29/2022]
Abstract
Granular cell tumour of the breast (GCTB) is a rare tumour which arises from Schwann cells. It is a largely benign tumour but in extremely rare cases can exhibit malignant characteristics. It poses a particular problem as it's characteristics can mimic breast carcinoma clinically, radiologically and macroscopically. This results in the potential misdiagnosis of breast carcinoma and over treatment of patients. Typically GCTBs are benign, solitary lesions but variations include malignant GCTBs, colocalisation with breast malignancies and multicentricity. These tumours can be investigated using mammography, ultrasound and magnetic resonance imaging. However none of these modalities have yet identified any GCTB specific characteristics. On pathological examination they can be identified using both microscopic and immunohistochemical features. The cells have a distinctive granular eosinophilic cytoplasm associated with typical nuclei and abundant lysosomes. Immunohistochemically they are positive for S100 protein, CD68 and neuron specific endolase (NSE). They are treated with wide local excision and while they may reoccur, are associated with a good prognosis.
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Affiliation(s)
- Anna C Brown
- Royal Sussex County Hospital, Eastern Road, Brighton, BN2 5BE, UK.
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9
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Cintora León E, Santamaría Peña M, Ibañez Calle MT. [Granular cell tumor of the breast]. RADIOLOGIA 2008; 50:46; discussion 88. [PMID: 18275788 DOI: 10.1016/s0033-8338(08)71937-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- E Cintora León
- Servicio de Radiodiagnóstico. Hospital de Basurto. Bilbao. España.
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11
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Montagnese MD, Roshong-Denk S, Zaher A, Mohamed I, Staren ED. Granular Cell Tumor of the Breast. Am Surg 2004. [DOI: 10.1177/000313480407000112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Granular cell tumors (GCT) are uncommon, usually benign, neoplasms that are thought to derive from Schwann cells of the peripheral nerves. They can originate anywhere in the body but are most frequently found in the head and neck, particularly in the oral cavity. When they are located in the breast, as may occur in 5–8 per cent of cases, the clinical and pathologic appearance is similar to that of a malignant tumor. Immunohistochemical analysis, including reactivity for periodic acid–Schiff, CD68, and S100 and negative reactivity for cytokeratin, is required for definitive diagnosis. Awareness of this tumor's unique characteristics might aid in differentiating it from the more common malignant tumors of the breast.
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Affiliation(s)
| | | | - Aiman Zaher
- Departments of Pathology, Medical College of Ohio, Toledo, Ohio
| | - Iman Mohamed
- Departments of Pathology, Medical College of Ohio, Toledo, Ohio
| | - Edgar D. Staren
- Departments of Surgery, Medical College of Ohio, Toledo, Ohio
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12
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Delaloye JF, Seraj F, Guillou L, Genton CY, Anciaux-Le Teno D, Schnyder P, De Grandi P. Granular cell tumor of the breast: a diagnostic pitfall. Breast 2002; 11:316-9. [PMID: 14965687 DOI: 10.1054/brst.2002.0421] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2001] [Revised: 01/17/2002] [Accepted: 01/29/2002] [Indexed: 11/18/2022] Open
Abstract
We report a rare case of benign granular cell tumor of the breast associated with multiple similar lesions of the scalp, the right shoulder, the right flank, the abdominal wall and the vulva, treated with wide excisions.
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Affiliation(s)
- J F Delaloye
- Department of Gynecology and Obstetrics, Institute of Pathology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
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13
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Lemos MM, Kindblom LG, Meis-Kindblom JM, Remotti F, Ryd W, Gunterberg B, Willén H. Fine-needle aspiration characteristics of hibernoma. Cancer 2001; 93:206-10. [PMID: 11391608 DOI: 10.1002/cncr.9030] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Hibernoma is a rare, benign lipomatous tumor with features of brown fat. The preoperative diagnosis of hibernoma is difficult at times because its clinical, radiographic, and fine-needle aspiration (FNA) characteristics overlap with those of liposarcoma. METHODS The preoperative FNA findings of eight surgically excised hibernomas from seven patients (three men and four women, ages 24-60 years) were reviewed. The cytologic features were compared with the histologic features of the corresponding surgical specimens as well as lipomatous tumors and other lesions that may cause confusion in the differential diagnosis. RESULTS The FNA cytologic features of the hibernomas were found to correspond well with their histologic appearance. The FNA findings included small, round, brown fat-like cells with uniform, small cytoplasmic vacuoles and regular, small, round nuclei; delicate branching capillaries; and variable numbers of mature fat cells. CONCLUSIONS The FNA cytologic features of hibernoma are characteristic and useful in the preoperative investigation of lipomatous tumors, particularly with regard to excluding a diagnosis of liposarcoma.
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Affiliation(s)
- M M Lemos
- Department of Pathology, Musculoskeletal Tumor Center, Sahlgrenska University Hospital, Gothenburg, Sweden
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Jin Y, Kuroda N, Kakiuchi S, Yamasaki Y, Miyazaki E, Hayashi Y, Toi M, Naruse K, Hiroi M, Enzan H. Bronchial granular cell tumor with osteopontin and osteonectin expression: a case report. Pathol Int 2000; 50:421-6. [PMID: 10849333 DOI: 10.1046/j.1440-1827.2000.01048.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The case of a 52-year-old Japanese man with bronchial granular cell tumors with osteopontin and osteonectin expression is reported here because there have been few investigations of their expression in benign tumors. He was admitted because of sudden hematemesis. A bronchoscopic examination revealed a lobulated polypoid tumor located in the left and right bronchi. Histologically, most tumor cells had abundant granular eosinophilic cytoplasm and were immunoreactive for S-100, neuron-specific enolase (NSE), CD68 and vimentin. Moreover, osteopontin-positive tumor cells were randomly distributed in the tumor tissue, but few stromal cells were positive. In contrast, osteonectin was mainly expressed in the peripheral tumor cells and was also distributed in the stromal cells. Blood vessels at the tumor border in which osteonectin-positive tumor cells were distributed, proliferated moderately. These results suggest that osteopontin and osteonectin may play a role in the progression of granular cell tumors and in the interaction between the tumor and host or angiogenesis around the tumor, respectively.
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Affiliation(s)
- Y Jin
- First Department of Pathology, Kochi Medical School, Nankoku City, Kochi, Japan
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Gibbons D, Leitch M, Coscia J, Lindberg G, Molberg K, Ashfaq R, Saboorian MH. Fine Needle Aspiration Cytology and Histologic Findings of Granular Cell Tumor of the Breast: Review of 19 Cases with Clinical/Radiologic Correlation. Breast J 2000; 6:27-30. [PMID: 11348331 DOI: 10.1046/j.1524-4741.2000.99017.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Granular cell tumors (GCTs) are rare lesions in the breast of putative schwannian origin. These tumors are found in multiple sites throughout the body and have a characteristic histologic appearance. Recognition of these usually benign tumors is important since clinically, radiologically, and grossly GCTs of the breast often mimic carcinoma. The literature on these lesions in the breast is confined to isolated case reports. We describe the epidemiologic, cytologic, pathologic, and radiologic findings in 19 GCTs of the breast in 16 patients diagnosed at the University of Texas Southwestern Medical Center between 1991 and 1997.
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Affiliation(s)
- D. Gibbons
- Departments of Pathology,Surgery, and Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
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Granular Cell Tumor of the Breast Diagnosed by Core Needle Biopsy: A Case Report. Breast Cancer 1999; 6:69-71. [PMID: 11091694 DOI: 10.1007/bf02966910] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Granular cell tumor rarely occurs in the breast. We report a 69-year-old woman with a right breast mass that simulated carcinoma on palpation, mammography, and ultrasonography. Aspiration biopsy cytology showed no malignant atypical cells. Core needle biopsy was performed to obtain an accurate diagnosis. The lesion was histologically confirmed to be a granular cell tumor. Immunostaining was positive for S-100 protein and vimentin, and negative for keratin, carcinoembryonicantigen, estrogen receptor and gross cystic disease fluid protein-15. The tumorwas treated by wide local excision. Surgeons should be aware that granular cell tumor can resemble breast cancer in order to avoid performing a needless radical mastectomy.
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