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Povzun SA, Novitskaya NY. [Breast granular cell tumor]. Arkh Patol 2024; 86:48-50. [PMID: 39073542 DOI: 10.17116/patol20248604148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
The report of the biopsy diagnosis of the granular cell tumor with rare localization in the breast is given. Currently, the tumor is considered a neoplasm of neuroectodermal origin. Differential diagnostic criteria for the tumor are positive expression in cytoplasm of protein S-100, absence of expression of epithelial antigens, histiocytic antigens, oncoproteins, estrogens and progesterone receptors, PAS-positive reaction of intracellular granules. With ultrasound examination and mammography, a tumor always initially assessed as cancer or calcification.
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Affiliation(s)
- S A Povzun
- I.I. Dzanelidze St. Petersburg Scientific Research Institute of Emergency Care, St. Petersburg, Russia
| | - N Yu Novitskaya
- I.I. Dzanelidze St. Petersburg Scientific Research Institute of Emergency Care, St. Petersburg, Russia
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2
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Rampi A, Tettamanti A, Bertotto I, Comini LV, Howardson BO, Luparello P, Di Santo D, Bondi S. Atypical Tongue Abscesses Mimicking Submucosal Malignancies: A Review of the Literature Focusing on Diagnostic Challenges. Cancers (Basel) 2023; 15:5871. [PMID: 38136415 PMCID: PMC10741429 DOI: 10.3390/cancers15245871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/06/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Tongue abscesses are rare conditions that usually follow mucosal disruption due to mechanical trauma or foreign body impaction. They typically manifest abruptly as a rapidly growing, hard mass or swelling in the context of tongue muscles; the patient frequently complains of pain, difficulties in swallowing or speaking, and fever. Nonetheless, the features of its presentation, together with accurate clinical evaluation, blood tests, and appropriate imaging tests, are usually sufficient to easily discern a tongue abscess from a malignancy. However, in rare cases, they may occur with slowly progressing and subtle symptoms, nuanced objective and laboratory findings, and inconclusive radiological evidence, leading to difficult differential diagnosis with submucosal malignancy. Herein, we review the literature, available on Pubmed, Embase, and Scopus, on publications reporting tongue abscesses, with atypical presentation suggesting an oral tumor. Our review confirms that tongue abscesses may manifest as a slowly growing and moderately painful swelling without purulent discharge and minimal mucosal inflammation; in this case, they may constitute an actual diagnostic challenge with potentially severe impact on correct management. Atypical tongue abscesses must therefore be considered in the differential diagnosis of tongue malignancy with submucosal extension, even when other diagnostic elements suggest a neoplasia; in this case, a deep biopsy under general anesthesia is essential for differential diagnosis, and simultaneous drainage of the necrotic and abscessual material may resolve the condition.
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Affiliation(s)
- Andrea Rampi
- Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.R.); (A.T.); (B.O.H.)
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Alberto Tettamanti
- Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.R.); (A.T.); (B.O.H.)
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Ilaria Bertotto
- Radiology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy;
| | - Lara Valentina Comini
- Otorhinolaryngology Unit, Head and Neck Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy; (L.V.C.); (P.L.); (D.D.S.)
| | - Bright Oworae Howardson
- Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.R.); (A.T.); (B.O.H.)
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Paolo Luparello
- Otorhinolaryngology Unit, Head and Neck Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy; (L.V.C.); (P.L.); (D.D.S.)
| | - Davide Di Santo
- Otorhinolaryngology Unit, Head and Neck Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy; (L.V.C.); (P.L.); (D.D.S.)
| | - Stefano Bondi
- Otorhinolaryngology Unit, Head and Neck Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy; (L.V.C.); (P.L.); (D.D.S.)
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Toh ZYC, Cooper T, Jessri M, Chang FSC. Unusual presentation of granular cell tumour of buccal mucosa. BMJ Case Rep 2021; 14:e242242. [PMID: 34544699 PMCID: PMC8454276 DOI: 10.1136/bcr-2021-242242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/03/2022] Open
Abstract
Granular cell tumour (GCT) is a rare soft tissue lesion which many consider to have malignant potential of yet unknown aetiopathogenesis. Oral GCT lesions may occur in an area of leucoplakia and are predominantly present on the tongue. This case study highlights an uncommon presentation of this condition located on the buccal mucosa and illustrates the need for meticulous evaluation of suspicious lesions. Due to the malignant risk associated with GCT lesions, it is important to make the correct diagnosis and ensure complete surgical excision for these cases. Ongoing long-term follow-up is also indicated to monitor for recurrence or malignancy.
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Affiliation(s)
- Zhi Yon Charles Toh
- Oral Maxillofacial Surgery, Auckland District Health Board, Auckland, New Zealand
| | - Thomas Cooper
- Oral Maxillofacial Registrar, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Maryam Jessri
- Oral Medicine, The University of Western Australia Faculty of Medicine Dentistry and Health Sciences, Nedlands, Western Australia, Australia
| | - Frank S-C Chang
- Oral and Maxillofacial Surgery, Royal Perth Hospital, Perth, Western Australia, Australia
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Lafuente Ibáñez de Mendoza I, López Ortega K, Trierveiler M, Oliveira Alves MG, Dias Almeida J, Gándara Vila P, Aguirre Urízar JM, Pérez Sayans M. Oral granular cell tumour: A multicentric study of 56 cases and a systematic review. Oral Dis 2020; 26:573-589. [PMID: 31898368 DOI: 10.1111/odi.13273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/02/2019] [Accepted: 12/26/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Granular cell tumour (GCT) is a benign neoplasm that originates from Schwann cells. Within the oral cavity, it usually appears as a lingual nodule and especially amongst female adults. Histologically, GCT shows a proliferation of polygonal cells with eosinophilic granular cytoplasm, which can be associated with a pseudoepitheliomatous hyperplasia (PEH). In this study, we analyse the main clinicopathological data of intraoral GCT and we compare our results with previous studies. MATERIAL AND METHODS We have studied a series of 56 cases of oral GCT in Spain and Brazil, and we have conducted a systematic review in PubMed, Web of Knowledge and Scopus databases, using the keywords: "granular cell tumour" and oral. RESULTS In our series, GCT appeared as an asymptomatic benign tumour that is more frequent in women and in the tongue. PEH was observed in 32% of the lesions. In the review, we collected 282 cases of oral GCT with a similar clinical profile; seven patients had multiple lesions, and 33% of the cases presented PEH. No cases of malignant oral GCT have been described to date. GCT is an uncommon oral benign neoplasm, mainly unique and asymptomatic, derived from Schwann cells. CONCLUSIONS Although the etiopathogenesis of this oral tumour is unknown, its characteristics suggest that it could have a reactive nature. Conducting a complete clinicopathological study in all intraoral GCT is fundamental in order to dismiss other entities, including oral carcinoma.
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Affiliation(s)
- Irene Lafuente Ibáñez de Mendoza
- Oral and Maxillofacial Pathology and Oral Medicine Unit, Department of Stomatology II, University of the Basque Country, Lejona, Spain
| | - Karem López Ortega
- Special Care Dentistry Centre (CAPE) and Oral Pathology, Department of Stomatology, University of São Paulo School of Dentistry (USP), São Paulo, Brazil
| | - Marília Trierveiler
- Special Care Dentistry Centre (CAPE) and Oral Pathology, Department of Stomatology, University of São Paulo School of Dentistry (USP), São Paulo, Brazil
| | | | - Janete Dias Almeida
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Pilar Gándara Vila
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, Universidade de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - José Manuel Aguirre Urízar
- Oral and Maxillofacial Pathology and Oral Medicine Unit, Department of Stomatology II, University of the Basque Country, Lejona, Spain
| | - Mario Pérez Sayans
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, Universidade de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
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Costa Almeida CE, Caroço T, Silva M, Albano MN. Abrikossoff's tumour on the upper limb: a rare presentation. BMJ Case Rep 2017; 2017:bcr-2017-222006. [PMID: 29127127 DOI: 10.1136/bcr-2017-222006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Abrikossoff's tumour or granular cell tumour is a rare entity. Most common locations are the head and neck, with only a few cases reported on the upper limbs. A 55-year-old man with a nodular lesion on the left arm resorted to surgery consultation. Nodule was firm, mobile, painless and non-ulcerated. Total excision using a Limberg flap procedure was performed. Following 3 months of follow-up, the patient is fine. Abrikossoff's tumour is frequently presented in the second to sixth decade of life as an ulcerated nodule with progressive growth. Malignant form is rare, with metastases occurring in up to 3% of patients. Excision must be accomplished with free margins. Recurrence is rare. Abrikossoff's tumour on the upper limbs is rare. Although benignity is the rule, doctors must be aware of the possibility of harbouring a cancer. Surgery is the treatment of choice.
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Affiliation(s)
- Carlos E Costa Almeida
- Department of Surgery C (Covões), Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Teresa Caroço
- Department of Surgery C (Covões), Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Marta Silva
- Department of Surgery C (Covões), Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Miguel Nico Albano
- Department of Surgery C (Covões), Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
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6
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Granular cell tumor in two oral anatomic sites. Eur Arch Otorhinolaryngol 2016; 273:3439-41. [DOI: 10.1007/s00405-016-4006-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 03/21/2016] [Indexed: 10/22/2022]
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Koshy J, Schnadig V, Nawgiri R. Is fine needle aspiration cytology a useful diagnostic tool for granular cell tumors? A cytohistological review with emphasis on pitfalls. Cytojournal 2014; 11:28. [PMID: 25379050 PMCID: PMC4220426 DOI: 10.4103/1742-6413.143304] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 08/21/2014] [Indexed: 12/29/2022] Open
Abstract
Background: Granular cell tumors (GCT) formerly known as Abrikossoff tumor or granular cell myoblastoma, are rare neoplasms encountered in the fine needle aspiration (FNA) service. Named because of their highly granular cytoplasm which is invariably positive for the S-100 antibody, the classic GCT is thought to be of neural origin. The cytomorphological features range from highly cellular to scanty cellular smears with dispersed polygonal tumor cells. The cells have abundant eosinophilic granular cytoplasm, eccentric round to oval vesicular nuclei with small inconspicuous nucleoli. The fragility of the cells can result in many stripped nuclei in a granular background. The differential diagnosis occasionally can range from a benign or reactive process to features that are suspicious for malignancy. Some of the concerning cytologic features include necrosis, mitoses and nuclear pleomorphism. Methods: We identified 6 cases of suspected GCT on cytology within the last 10 years and compared them to their final histologic diagnoses. Results: Four had histologic correlation of GCT including one case that was suspicious for GCT on cytology and called atypical with features concerning for a malignant neoplasm. Of the other two cases where GCT was suspected, one showed breast tissue with fibrocystic changes, and the other was a Hurthle cell adenoma of the thyroid. Conclusions: These results imply that FNA has utility in the diagnosis of GCT, and should be included in the differential diagnoses when cells with abundant granular cytoplasm are seen on cytology. Careful attention to cytologic atypia, signs of reactive changes, use of immunohistochemistry, and clinical correlation are helpful in arriving at a definite diagnosis on FNA cytology.
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Affiliation(s)
- Jason Koshy
- Address: Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555-0548, United States
| | - Vicki Schnadig
- Address: Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555-0548, United States
| | - Ranjana Nawgiri
- Address: Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555-0548, United States
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Pushpa G, Karve PP, Subashini K, Narasimhan MN, Ahmad PB. Abrikossoff's Tumor: An Unusual Presentation. Indian J Dermatol 2013; 58:407. [PMID: 24082205 PMCID: PMC3778800 DOI: 10.4103/0019-5154.117335] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abrikossoff's tumor or granular cell tumor is an infrequent benign neoplasm, first described by the Russian pathologist Abrikossoff in 1926. The neoplasm can affect all parts of the body with head and neck areas affected in 45-65% of patients. More than half of the head and neck lesions are localized to the oral cavity, especially the tongue. An aggressive malignant form of granular cell myoblastoma that metastasizes is rare. The treatment of choice of Abrikossoff's tumor is local surgical excision with a wide margin. Here, we present a case of Abrikossoff's tumor, occurring in the upper arm, presenting as a panniculitis-like lesion.
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Affiliation(s)
- Gnanaraj Pushpa
- Department of Dermatology, SRM Medical College Hospital and Research Centre, Kattankulathur, Kancheepuram, Tamilnadu, India
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Hita-Davis P, Edwards P, Conley S, Dyer T. Granular cell tumour of the tongue in a 17-year-old orthodontic patient: a case report. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/ors.12055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P. Hita-Davis
- Oral Maxillofacial Surgery; School of Dentistry; Ann Arbor MI USA
| | - P. Edwards
- Department of Oral Pathology, Medicine and Radiology; Indiana University; Indianapolis IN USA
| | - S. Conley
- Department of Orthodontics and Pediatric Dentistry; University of Michigan; Ann Arbor MI USA
| | - T.J. Dyer
- Oral Surgery; Boston University; Boston MA USA
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Gomes CC, Fonseca-Silva T, Gomez RS. Evidence for loss of heterozygosity (LOH) at chromosomes 9p and 17p in oral granular cell tumors: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:249-53. [PMID: 23312918 DOI: 10.1016/j.oooo.2012.11.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 10/25/2012] [Accepted: 11/04/2012] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The objective of this study was to assess loss of heterozygosity (LOH) in tumor suppressor gene loci in oral granular cell tumors (GCTs). STUDY DESIGN We assessed LOH in 8 samples of oral GCT using polymorphic microsatellite markers at chromosome regions 3p, 9p, 11q, and 17p, flanking areas close to tumor suppressor genes. We further performed immunohistochemistry to detect the p53 and Ki-67 proteins and associated these expressions with the molecular results. RESULTS Five samples showed LOH in 3 markers at chromosomes 9p and 17p (markers P53, AFM238WF2 and D9S162) with fraction of allelic loss of 42.8% for each of these markers. No LOH was identified in any other chromosome. LOH was not associated with the immunohistochemical expression of p53 and Ki-67. CONCLUSIONS The present study shows LOH at chromosomes 9p and 17p in oral GCTs.
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Affiliation(s)
- Carolina Cavaliéri Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Sena Costa NC, Bertini F, Carvalho YR, Almeida JD, Rodrigues Cavalcante AS. Granular cell tumor presenting as a tongue nodule: two case reports. J Med Case Rep 2012; 6:56. [PMID: 22325570 PMCID: PMC3298519 DOI: 10.1186/1752-1947-6-56] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 02/10/2012] [Indexed: 11/16/2022] Open
Abstract
Introduction Granular cell tumor is an uncommon neoplasm that can occur in any part of the body, including the orofacial region. The tumor is usually benign, but there are reports of cases in which the tumor shows a locally aggressive behavior, malignancy, and distant metastases. The most widely accepted hypothesis is that granular cell tumor arises from the altered metabolism of Schwann cells. The tumor is typically asymptomatic and appears as a nodule that does not exceed 3 cm. Case presentation In case 1, a 26-year-old Caucasian man was seen at the Oral Medicine out-patient clinic of the São José dos Campos Dental School, Universidade Estadual Paulista, with a 'small blister on the tongue', which he had noted approximately three years ago. The nodule was located on the dorsum of the tongue, measured about 1.5 cm in diameter, and was not tender to palpation. Treatment consisted of an excisional biopsy performed on the basis of the diagnostic hypothesis of granular cell tumor, which was confirmed by microscopic analysis. In case 2, a 31-year-old Caucasian woman attended the out-patient clinic of the São José dos Campos Dental School, Universidade Estadual Paulista, with a five-year history of a 'painful lump on the tongue'. Intra-oral examination revealed the presence of a nodular lesion measuring approximately 0.8 cm in diameter, which was located deep in the submucosa of the right lateral margin of the tongue. Treatment consisted of an excisional biopsy performed on the basis of the differential diagnosis of neurofibroma and granular cell tumor. Microscopic analysis defined the final diagnosis of granular cell tumor. Conclusions Granular cell tumor is an uncommon tumor that must be carefully diagnosed and treated correctly.
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Affiliation(s)
- Nivea Cristina Sena Costa
- Department of Bioscience and Oral Diagnosis, São José dos Campos Dental School, São José dos Campos, UNESP - Univ Estadual Paulista, São Paulo, Brazil.
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de Sousa SF, Caldeira PC, de Mattos Camargo Grossmann S, de Aguiar MCF, Mesquita RA. Desmoplastic fibroblastoma (collagenous fibroma): a case identified in the buccal mucosa. Head Neck Pathol 2011; 5:175-9. [PMID: 21221866 PMCID: PMC3098328 DOI: 10.1007/s12105-010-0239-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 12/22/2010] [Indexed: 10/18/2022]
Abstract
Desmoplastic fibroblastoma is a rare, benign, soft tissue tumor affecting mainly the subcutaneous and muscle tissue. Only five cases identified in the oral cavity have been reported in prior literature. This article presents a case report of a 56-year-old man, with no previous history of trauma, who presented a slow-growing mass in the buccal mucosa. Histopathology and immunohistochemistry staining studies were performed, and a diagnosis of the desmoplastic fibroblastoma was made. The patient has been disease-free for one year.
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Affiliation(s)
- Sílvia Ferreira de Sousa
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Patrícia Carlos Caldeira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Soraya de Mattos Camargo Grossmann
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Maria Cássia Ferreira de Aguiar
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
- Faculdade de Odontologia, Departamento de Clínica, Patologia e Cirurgia Odontológicas, Universidade Federal de Minas Gerais, Av.: Antônio Carlos, 6627, Sala 3202-D, Pampulha, 31.270-901 Belo Horizonte, Minas Gerais Brazil
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Gammon BL, Gleason BC, Thomas AB, Cibull TL. Sarcomatoid renal cell carcinoma presenting in the oropharynx. J Cutan Pathol 2011; 37:1255-8. [PMID: 20590964 DOI: 10.1111/j.1600-0560.2010.01578.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Metastasis stemming from a distant malignancy is far less common than an oropharyngeal primary and represents only 1% of all oral neoplasms. The difficulty in diagnosing a metastasis in the oropharynx may be compounded if the lesion is poorly differentiated and bears little resemblance to the primary tumor. We present the case of synchronous metastatic renal cell carcinoma of the mandibular gingiva in a woman with sarcomatoid clear cell renal cell carcinoma. The metastatic lesion was poorly differentiated and lacked expression of the renal cell carcinoma (RCC) antigen. In contrast, PAX-8 staining was strongly positive. This case serves to highlight the diagnostic difficulty posed by poorly differentiated lesions in the oropharynx and reinforces the sensitivity of the cell lineage-specific transcription factor PAX-8 in poorly differentiated RCC.
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Affiliation(s)
- Bryan Leigh Gammon
- Department of Dermatology, Northwestern University, Chicago, IL 60611, USA.
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A forgotten facial nerve tumour: granular cell tumour of the parotid and its implications for treatment. The Journal of Laryngology & Otology 2010; 125:410-4. [PMID: 21106139 DOI: 10.1017/s002221511000246x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We present a rare case of a facial nerve granular cell tumour in the right parotid gland, in a 10-year-old boy. A parotid or neurogenic tumour was suspected, based on magnetic resonance imaging. Intra-operatively, strong adhesions to surrounding structures were found, and a midfacial nerve branch had to be sacrificed for complete tumour removal. Recent reports verify that granular cell tumours arise from Schwann cells of peripheral nerve branches. The rarity of this tumour within the parotid gland, its origin from peripheral nerves, its sometimes misleading imaging characteristics, and its rare presentation with facial weakness and pain all have considerable implications on the surgical strategy and pre-operative counselling. Fine needle aspiration cytology may confirm the neurogenic origin of this lesion. When resecting the tumour, the surgeon must anticipate strong adherence to the facial nerve and be prepared to graft, or sacrifice, certain branches of this nerve.
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