Granular Cell Tumor: A Clinical Study of 81 Patients

Oral granular cell tumor: a collaborative clinicopathological study of 61 cases

BACKGROUND

Granular Cell Tumor (GCT) is an uncommon benign lesion in the oral cavity whose pathogenesis remains poorly understood. Due to their infrequent occurrence and similarity to other oral lesions, they are often forgotten during the initial clinical diagnosis. Therefore, understanding its prevalence, clinical and pathological characteristics is crucial for an accurate diagnosis and adequate management.

METHODS

All cases diagnosed as GCTs in six Brazilian and Argentinian oral diagnostic centers were re-evaluated by HE staining, and clinical, demographic, and histopathological data were collected and evaluated.

RESULTS

The series comprised 45 female (73.8%) and 16 male (26.2%), with a 2.8:1 female-to-male ratio and a mean age of 35.3 ± 16.9 years (range: 7-77 years). Most cases occurred on the tongue (n = 49; 81.6%) and presented clinically as asymptomatic papules or nodules (n = 50; 89.3%) with a normochromic (n = 25; 45.5%) or yellowish (n = 11; 20.0%) coloration and sizes ranging from 0.2 to 3.0 cm (mean ± SD: 1.40 ± 0.75 cm). Morphologically, most tumors were characterized by a poorly delimited proliferation (n = 52; 88.1%) of cells typically rounded to polygonal containing abundant, eosinophilic, finely granular cytoplasm. Pustulo-ovoid bodies of Milian were identified in all lesions (n = 61; 100%). Entrapment of skeletal striated muscle (n = 44; 72.1%) and nerve fibers (n = 42; 68.9%) were common findings. Pseudoepitheliomatous hyperplasia (PEH) was observed in 23 cases (39.0%). In only 27.7% of cases (n = 13) there was agreement between the clinical and histopathological diagnosis. Outcome information was available from 16 patients (26.2%), with clinical follow-up ranging from 4 to 36 months (mean 13.3 months), and none developed local recurrence.

CONCLUSIONS

The clinical and histopathological features of GCTs were consistent with those described in previous studies. In general, these lesions have a predilection for the lateral region of the tongue in adult women. It is essential to consider GCTs in the differential diagnosis of yellow or normochromic papules and nodules in the oral cavity. Histopathological evaluation is essential for the definitive diagnosis and the prognosis is excellent.

Case report: Abrikossoff's tumor of the facial skin

Abrikossoff tumors, also known as granular cell tumors (GCT), originate from Schwann cells. The most common location is in the oral cavity, followed by the skin, but they can also be found in the breast, digestive tract, tracheobronchial tree, or central nervous system. They can affect both sexes at any age, with a higher incidence between 30 and 50 years and a slight predisposition for female sex. They are usually solitary tumors but may also be multifocal. Most of the time, they are benign, with malignancy being exceptional in <2% of cases. Clinically, they appear as solid, well-defined, painless tumors, located subcutaneously with dimensions that can reach up to 10 cm. The definitive diagnosis is based on the immunohistochemical examination, and the treatment for benign tumors consists of surgical excision. Chemotherapy or radiotherapy may be required for malignant lesions, but the treatment regimens and their benefits remain unclear. This manuscript presents the case of a 12-year-old girl with a benign GCT, located in the skin on the mandibular line.

Recurrent primary cutaneous granular cell tumor of the neck in an Asian women: A case report

INTRODUCTION AND IMPORTANCE

Granular cell tumors are uncommon neoplasms. They appear in the skin, subcutaneous tissues, and many internal organs. It is essential to diagnose this disease because it mimics other tumors clinically. We report this case because of the rarity of tumors in Asians and the necessity of excision with clear margins.

CASE PRESENTATION

A 55-year-old Indian woman reported swelling in the right side of the neck for six months and gradually increasing in size. Two years ago, she had a similar swelling excised from her neck. She had wide local excision of the tumor with wider margins in the plastic surgery department, and histopathology revealed a granular cell tumor with clear margins. She is undergoing close follow-up with history and physical examination with no evidence of disease recurrence.

CLINICAL DISCUSSION

Granular cell tumors can have recurrences. These slow-growing tumors appear benign. Histopathological examination with careful assessment of high-risk features is vital in evaluating Granular cell tumors. Wide local excision with clear margins is the mainstay of treatment.

CONCLUSION

Achieving clear margins in the head and neck area is sometimes tricky for granular cell tumors. Margin positivity is associated with a high risk of local recurrence and needs re-excision of the tumor for adequate local control.

Abrikossoff's tumor of the penis: a case report

Background

Granular cell tumors (GCTs) also called Abrikossoff's tumor are rare tumors of often benign neurogenic origin, mainly located in the craniocervical region, rarely found in the external genitals. We report in this article the case report of a purely cutaneous case of rare clinical presentation at the level of the penis.

Case presentation

We report the case of a man, aged 54, with no history, consulted for a nodular lesion on the penis evolving for a year. a nodular cutaneous plate, indurated 3 cm in large diameter, painless and mobile in relation to the deep plane. The lymph node areas were free, and the remainder of the skin examination was without abnormalities.

Conclusions

Granular cell tumors (GCTs) also called Abrikossoff's tumor are rare tumors of often benign neurogenic origin, mainly located in the craniocervical region, rarely found in the external genitalia, the diagnosis is based on anatomopathology study completed by immunohistochemistry, and treatment consists of complete surgical excision of the tumor.

Granular Cell Tumor in a 13-Year-Old Girl

Granular cell tumors are rare benign soft-tissue lesions that most commonly occur in the head and neck. They usually present in adulthood and are rarely seen in children. Here we present a 13-year-old girl who experienced symptoms of hoarseness of voice for most of her childhood and was unsuccessfully treated for asthma, acid reflux, allergies, and bronchitis before direct visualization revealed what was initially thought to be a vocal cord cyst. Surgical excision and pathology revealed the unexpected diagnosis of a vocal cord granular cell tumor. The patient has had resolution of dysphonia and is undergoing voice therapy.

Multifocal Cutaneous Granular Cell Tumor in Children: A Rare Entity

ABSTRACT

Granular cell tumors (GCTs) are rare soft tissue tumors of Schwann cell origin that manifest as papulonodular lesions and occur mainly in adults. The diagnosis is usually confirmed by histopathology. Most of GCTs are benign, but some lesions may exhibit malignant criteria. This study is a retrospective case series including all children with histopathologically documented multiple GCTs who attended the dermatology department of the university hospitals between February 2008 and March 2021. The objective of our study was to raise awareness to this unrecognized and rare entity in such age group. The study included 9 patients (6 girls and 3 boys) with multiple GCTs. Their age ranged between 5 and 13 years. The lesions were skin-colored to light brown, firm, smooth-surfaced nodules. Most of the lesions were on the extremities, and their mean diameter was 160.5 mm2. None of the lesions exhibited any malignant criteria on histopathology. No extracutaneous or mucosal lesions were detected. Dermatologists should be aware of this rare condition in children because early recognition allows more conservative resection of the tumor and less invasive reconstruction of the defect. Our study highlights that multifocality does not necessarily indicate malignancy or other systemic comorbidities.