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Moon HH, Jin K, Choi YJ, Cho KJ, Lee YS, Lee JH. Imaging findings of granular cell tumours of the head and neck. Clin Radiol 2023; 78:e1075-e1080. [PMID: 37806818 DOI: 10.1016/j.crad.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/08/2023] [Accepted: 09/02/2023] [Indexed: 10/10/2023]
Abstract
AIM To review the imaging characteristics of granular cell tumours in the head and neck and assess their associations with pathological findings. MATERIALS AND METHODS Eleven patients (10 [91%] women, mean age 43 years) with histopathologically confirmed granular cell tumours were included in this study. Preoperative imaging studies were performed, including computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound. The location of the tumours, their imaging features, and histopathological findings were analysed. RESULTS Among the 11 granular cell tumours, four (36%), three (27%), and two (18%) tumours were found in the submucosal layer, subcutaneous layer, and intramuscular area, respectively. On CT, all tumours exhibited homogeneous iso-attenuating enhancement compared with adjacent muscle, and nine out of the 11 tumours (81%) demonstrated well-defined margins. On T2-weighted imaging (T2WI), four out of five tumours (80%) demonstrated iso-signal intensity compared with adjacent muscles, and four tumours (80%) exhibited homogeneous signal intensity. The apparent diffusion coefficient (ADC) values ranged from 0.68-0.81 × 10-3 mm2/s. Histopathological examination revealed densely packed tumour cells with variable amounts of fibrous stroma. CONCLUSION Granular cell tumours were characterised by well-defined and iso-signals on T2WI and low mean ADC values, and were predominantly located in the submucosal, subcutaneous, or intramuscular areas in middle-aged women. The characteristic locations, demographic characteristics, and imaging findings can help to differentiate granular cell tumours from other soft-tissue tumours in the head and neck.
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Affiliation(s)
- H H Moon
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - K Jin
- Department of Health Care Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Y J Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
| | - K-J Cho
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Y S Lee
- Department of Otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - J H Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Pezzulla D, Di Franco R, Zamagni A, Pastore F, Longo S, Dominici L, Lillo S, Ciabattoni A, Arcidiacono F, Deodato F, Muto P, Morganti AG, Cellini F, Maranzano E. Radiotherapy of orbital metastases: a systematic review of management and treatment outcomes on behalf of palliative care study group of Italian association of radiotherapy and clinical oncology (AIRO). Br J Radiol 2023; 96:20230124. [PMID: 37751164 PMCID: PMC10607395 DOI: 10.1259/bjr.20230124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/09/2023] [Accepted: 08/21/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVES We search the current literature on data regarding the role of RT in OM treatment, focusing on the improvement of symptoms and patient quality of life. METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. RESULTS From 340 citations, 60 papers were finally selected: 45 case reports and 15 case series. The case reports accounted for 47 patients. In 37/39 cases (95%), EBRT was done. Patients were mainly treated with 3DCRT, IMRT, and with SBRT. The most used RT regimens were 30 Gy in 10 fractions (23%) and 20-25 Gy in 5 fx (13%). No sever toxicity was reported. A median LC of 11 months (range 1-54 months) and a median OS of 12 months (range 1-54 months) were registered. Among the case series, a total of 457 patients were examined, 227 of whom underwent RT. The main used techniques were 3DCRT, CK, GK, SBRT, and BRT. RT doses could vary from 30 Gy/10 fractions to 60 Gy/30 fractions, 50 Gy/5 fractions, or 16.5-21 Gy in single fraction. No toxicity above G2 was reported. ORR could vary between 75 and 100%. Only two study provided information on response duration: a mean LC time of 22.8 months and a mean time to local progression of 5 months (range: 3-7). Regarding OS, the data were heterogeneous, ranging between 1 and 54 months. CONCLUSIONS RT for OM seems to be a safe and feasible option. More information on the RT ideal techniques and dose are still needed. ADVANCES IN KNOWLEDGE This paper tried to sum up the few and fragmented data on the use of radiotherapy for orbital metastases: the possible option ranged from 3D- and 2D-CRT to SBRT, CK, and GK, with different possible fractionations (30Gy in 10 fractions, 60 Gy/30 fractions, 20-50 Gy/5 fractions, or 16.5-21 Gy in single fraction). Regardless of the chosen approach, almost all treated patients experienced a benefit after RT in terms of OM-related symptom intensity reduction and a good acute and late toxicity profile.
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Affiliation(s)
- Donato Pezzulla
- Radiation Oncology Unit, Responsible Research Hospital, Largo A. Gemelli 1, Campobasso, Italy
| | - Rossella Di Franco
- Department of Radiation Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Alice Zamagni
- Radiation Oncology, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum-Bologna University, Bologna, Italy
| | - Francesco Pastore
- Dipartimento di Diagnostica Per Immagini, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - Silvia Longo
- Dipartimento di Diagnostica Per Immagini, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - Luca Dominici
- Department of Radiotherapy, Humanitas Clinical and Research Center–IRCCS, Rozzano, Milan, Italy
| | - Sara Lillo
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | | | | | - Paolo Muto
- Department of Radiation Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | | | - Francesco Cellini
- Dipartimento di Diagnostica Per Immagini, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - Ernesto Maranzano
- University of Perugia-Faculty of Medicine and Surgery Radiotherapy Oncology Centre-“S. Maria” Hospital, Terni, Italy
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Lin GY, Liu Y, Ye T, Lu XY, Gao J, Wang YZ. Granular cell tumor of the vulva: Case report and systematic review of the literature. Medicine (Baltimore) 2022; 101:e32568. [PMID: 36595970 PMCID: PMC9803509 DOI: 10.1097/md.0000000000032568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 12/31/2022] Open
Abstract
RATIONALE Granular cell tumor (GCT) of the vulva is an exceptionally rare female genital tract tumor. The majority of these are benign and there are no standardized surgical techniques for the special site to reduce tension of the wound. PATIENT CONCERNS A 47-years-old Chinese woman experienced a nodule on her right vulva with itch sometimes in late 2018. DIAGNOSES Magnetic resonance imaging showed a high possibility of vulvar cancer. While Chest X-ray, abdominal sonography, and cystoscopy examination were unremarkable. INTERVENTIONS The patient underwent local complete resection of vulvar tumor under general anesthesia on March 24, 2022. The resection scope was approximately 4 cm × 3 cm × 3 cm. Due to the large surgical incision, Z-plasty was performed to achieve the primary closure for decreasing wound tension and improving aesthetic reduction. OUTCOMES The final pathological diagnosis was benign GCT of the vulva and surgical margins were uninvolved. At 8 months follow-up, no new lesions were detected. LESSONS Surgery with negative resection margins is the mainstay for benign GCT of the vulva, while Z-plasty is appropriate for decreasing the tension of the wound and improving aesthetic reduction.
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Affiliation(s)
- Guang-Yao Lin
- Department of Gynecology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Liu
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Tao Ye
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Xin-Yu Lu
- Department of Radiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Jie Gao
- Department of Pathology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Yong-Zhou Wang
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
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Takeda Y, Kaburaki T, Kakehashi A, Suzuki S. Granular cell tumour in the ciliary body. BMJ Case Rep 2022; 15:15/12/e252691. [PMID: 36581359 PMCID: PMC9806014 DOI: 10.1136/bcr-2022-252691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Granular cell tumours (GCTs) are benign tumours that rarely develop in intraocular regions. We report a rare case of intraocular GCT in the ciliary body. A woman in her 20s with a history of bone marrow transplantation for malignant lymphoma in early childhood was referred to our department for bilateral proliferative diabetic retinopathy. A yellowish-white ciliary tumour was observed in the temporal periphery of the patient's left eye during routine ophthalmological examination. As the tumour enlarged, we performed total resection combined with vitrectomy, silicone oil tamponade and cataract surgery. Histopathological examination revealed tumour cells with small, round or oval nuclei with eosinophilic cytoplasm. Positive immunohistochemical staining for S-100 and vimentin led to a diagnosis of ciliary GCT. No retinal detachment, proliferative membrane formation or tumour recurrence was observed 4 years postoperatively. Intraocular GCT should be considered a differential diagnosis of ciliary tumours.
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Affiliation(s)
- Yoshiharu Takeda
- Department of Ophthalmology, Jichi Ika Daigaku Fuzoku Saitama Iryo Center, Saitama, Japan
| | - Toshikatsu Kaburaki
- Department of Ophthalmology, Jichi Ika Daigaku Fuzoku Saitama Iryo Center, Saitama, Japan
| | - Akihiro Kakehashi
- Department of Ophthalmology, Jichi Ika Daigaku Fuzoku Saitama Iryo Center, Saitama, Japan
| | - Shigenobu Suzuki
- Department of Ophthalmic Oncology, Kokuritsu Gan Kenkyu Center Kenkyujo, Chuo-ku, Tokyo, Japan
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Barrantes PC, Zhou P, MacDonald SM, Ioakeim-Ioannidou M, Lee NG. Granular Cell Tumor of the Orbit: Review of the Literature and a Proposed Treatment Modality. Ophthalmic Plast Reconstr Surg 2022; 38:122-131. [PMID: 34406152 DOI: 10.1097/iop.0000000000002038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To document a unique case of granular cell tumor of the orbit, located lateral to and abutting the optic nerve, that benefited from treatment with proton beam irradiation, with a comprehensive review of the literature on granular cell tumor of the orbit. METHODS Clinicopathologic case report with detailed imaging features and histopathologic and immunohistochemical evaluation for cytoplasmic tumor biomarkers differentiating granular cell tumor (GCT) from it mimicking lesions with relevant literature citations. The authors reviewed 20 cases of orbital GCT from 2011 to 2020 in addition to 40 cases from 1948 to 2011 and included a summary of imaging and clinical features, outcomes, and recommended treatment modalities. RESULTS A 32-year-old man with 1-year history of left retrobulbar pain and diplopia on lateral gaze, intermittent left eyelid swelling, and a tonic left pupil was found to have a fusiform intraconal mass extending toward the orbital apex and abutting the optic nerve. Histopathologic and immunohistochemical investigations collectively supplied data diagnostic of a GCT with an initial low proliferation rate. GCT is a soft tissue neoplasm that originates in the nervous system and can occur anywhere in the body. This enhancing tumor is isointense to gray matter on T1-weighted MRI, hypointense on T2. After an incisional biopsy, the patient's symptoms persisted, and follow-up imaging several months later revealed further growth of the mass. The impossibility of complete surgical removal prompted the decision to treat with proton beam radiation therapy, which resulted in substantial regression in the size of the residual tumor. Most frequently involving the inferior rectus muscle (42%), orbital GCT is usually benign with only 4 reported cases of malignant orbital GCT (7%). Wide surgical resection with complete removal is usually curative for benign orbital GCT, and proton beam radiation therapy can aid in tumor shrinkage. CONCLUSIONS GCT should be considered in the differential diagnosis when encountering patients with mass lesions involving the extraocular muscles, peripheral nerves, or less frequently, the optic nerve or orbital apex. Immunohistochemical analysis of biopsied tissue is required for the definitive diagnosis of GCT. Consideration of adjuvant therapies such as proton beam radiation therapy may be appropriate in cases of incomplete surgical resection of benign GCT. Proton beam radiation therapy can be an excellent therapeutic option for symptomatic relief and residual tumor size reduction with an acceptable toxicity profile.
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Affiliation(s)
- Paula Cortes Barrantes
- David G. Cogan Laboratory of Ophthalmic Pathology, Department of Ophthalmology, Massachusetts Eye and Ear/Harvard Medical School
| | - Paul Zhou
- Division of Ophthalmic Plastic Surgery, Department of Ophthalmology, Massachusetts Eye and Ear/Harvard Medical School
| | - Shannon M MacDonald
- Massachusetts General Hospital Department of Radiation Oncology/Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Myrsini Ioakeim-Ioannidou
- Massachusetts General Hospital Department of Radiation Oncology/Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Nahyoung Grace Lee
- Division of Ophthalmic Plastic Surgery, Department of Ophthalmology, Massachusetts Eye and Ear/Harvard Medical School
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Dauder Gallego C, Ruiz Zafra J, Stanescu RI, Trujillo Coronado M, Mena Rosón MA, Fahandezh-Saddi Díaz H. Granular Cell Tumor of the Hand: Unusual Malignancy of a Previous Benign Lesion: A Case Report. JBJS Case Connect 2021; 11:01709767-202109000-00061. [PMID: 35102036 DOI: 10.2106/jbjs.cc.20.00503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
CASE Malignant granular cell tumors are uncommon soft-tissue tumors. We describe a granular cell tumor that presented as a benign hand nodule diagnosed by biopsy and image. The patient refused local excision. After 15 years, the patient came back because of symptomatic growth, and a malignant granular cell tumor was diagnosed, with metastatic disease. Despite surgical disarticulation and adjuvant treatment, she died after 8 months. The pathological examination revealed the tumor had progressed to malignant behavior. CONCLUSIONS Our findings highlight the importance of a closer follow-up. Although unusual, we must be aware of the possibility of a change of behavior from benign to malignant granular cell tumor.
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Affiliation(s)
- Cristina Dauder Gallego
- Department of Hand Orthopaedic Surgery, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Jorge Ruiz Zafra
- Department of Hand Orthopaedic Surgery, Hospital Universitario Fundación Alcorcón, Madrid, Spain
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Malignant granular cell tumor of the median nerve: a case report with a literature review of 157 cases. Skeletal Radiol 2019; 48:307-316. [PMID: 29980826 DOI: 10.1007/s00256-018-3017-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 06/15/2018] [Accepted: 06/18/2018] [Indexed: 02/02/2023]
Abstract
Malignant granular cell tumors are an extremely rare, high-grade sarcoma with a schwannian phenotype and are composed of malignant granular cells with cytoplasmic lysosomal inclusion. To date, 157 cases of malignant granular cell tumors have been reported. We report the first case of a malignant granular cell tumor arising from the digital nerve to the median nerve in the palm, and we review the 157 previously reported cases and summarize the clinical profile, treatment, and outcome of this tumor. The median age, tumor size, and follow-up periods were 51 years, 6 cm, and 24 months respectively. With respect to the oncological result, 53 patients (33.8%) had no evidence for disease, 31 (19.7%) were alive with the disease, and 51 (32.5%) died because of the disease. Our case report indicates that rare malignant tumors can arise from the digital nerve to the median nerve in the palm, an anatomical site that is usually affected by benign lesions. Exhaustive discussions between surgeons and pathologists are necessary for the treatment of this rare malignant tumor.
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8
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Abtahi J, Malakuti I, Ajan A. Surgical Management of Granular Cell Tumor of the Orbit: Case Report and Literature Review. Open Dent J 2019. [DOI: 10.2174/1874210601913010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:Granular Cell Tumors (GCTs) of the orbit are rare-entity soft-tissue tumors, and few reports have been published in the literature. The treatment of the choice is total excision. Early diagnosis prior to surgery is valuable for the distinction of malignant from benign tumor.Case presentation:We report a case of a 55-year-old woman with a solitary slow-growing mass in the right orbit with the involvement of the rectus inferior muscle, and present a review of the recent literature. The lesion had a diameter of 1 cm and was noticed 2 years before the examination. Excisional biopsy confirmed the diagnosis of GCT. The tumor was resected through a retroseptal transconjunctival approach. The final histological examination revealed findings characteristic of GCT, including positive reaction for protein S-100, SOX10, and calcitonin and negative reaction for desmin, myogenin, Smooth Muscle Antigen (SMA), Melan-A, and HMB-45. There were no signs of malignancy in this sample. Disturbance of motility was not noted by the patient after surgery.Conclusion:GCT should be included in the differential diagnosis of intraorbital lesions, particularly those that involve the orbit muscles. A biopsy is recommended before surgical resection, to exclude malignancy and prevent radical resection.
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Yang D, McLaren S, Van Vliet C, deSousa JL, Gajdatsy A. Progressive orbital granular cell tumour associated with medial rectus. Orbit 2017; 36:356-358. [PMID: 28700258 DOI: 10.1080/01676830.2017.1337181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Granular cell tumour is a rare soft tissue tumour that can occur in any part of the body, but seldom in ocular adnexa. It usually behaves in a benign fashion. We report a case of a 54-year-old man with a well-demarcated, solitary, slow-growing orbital tumour which lead to significant ocular symptoms. The case was a diagnostic and therapeutic challenge due to its location and difficulty in obtaining tissue for a histological diagnosis. Surgical biopsy attempts were made but they all failed to uncover the true identity of the lesion. A definitive diagnosis was revealed with complete surgical excision of the tumour, which was challenging due to its size and close association with rectus muscle. This case has highlighted that orbital granular cell tumour may result in significant ocular symptoms. Adequate exposure to the anatomical site is the key to obtaining diagnosis and complete excision of a lesion.
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Affiliation(s)
- David Yang
- a Sir Charles Gairdner Hospital , Perth , Australia
| | | | | | | | - Adam Gajdatsy
- a Sir Charles Gairdner Hospital , Perth , Australia.,b Lions Eye Institute , Perth , Australia
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Yuan WH, Lin TC, Lirng JF, Guo WY, Chang FP, Ho DMT. Computed tomography and magnetic resonance imaging findings of intraorbital granular cell tumor (Abrikossoff's tumor): a case report. J Med Case Rep 2016; 10:119. [PMID: 27176551 PMCID: PMC4866422 DOI: 10.1186/s13256-016-0896-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 04/10/2016] [Indexed: 11/30/2022] Open
Abstract
Background Granular cell tumors are rare neoplasms which can occur in any part of the body. Granular cell tumors of the orbit account for only 3 % of all granular cell tumor cases. Computed tomography and magnetic resonance imaging of the orbit have proven useful for diagnosing orbital tumors. However, the rarity of intraorbital granular cell tumors poses a significant diagnostic challenge for both clinicians and radiologists. Case presentation We report a case of a 37-year-old Chinese woman with a rare intraocular granular cell tumor of her right eye presenting with diplopia, proptosis, and restriction of ocular movement. Preoperative orbital computed tomography and magnetic resonance imaging with contrast enhancement revealed an enhancing solid, ovoid, well-demarcated, retrobulbar nodule. In addition, magnetic resonance imaging features included an intraorbital tumor which was isointense relative to gray matter on T1-weighted imaging and hypointense on T2-weighted imaging. No diffusion restriction of water was noted on either axial diffusion-weighted images or apparent diffusion coefficient maps. Both computed tomography and magnetic resonance imaging features suggested an intraorbital hemangioma. However, postoperative pathology (together with immunohistochemistry) identified an intraorbital granular cell tumor. Conclusions When intraorbital T2 hypointensity and free diffusion of water are observed on magnetic resonance imaging, a granular cell tumor should be included in the differential diagnosis of an intraocular tumor.
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Affiliation(s)
- Wei-Hsin Yuan
- Division of Radiology, Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), No.12, 225 Lane, Zhi-Sing Road, Taipei, Taiwan, 11260. .,Department of Radiology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan, 11217. .,School of Medicine, National Yang Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan.
| | - Tai-Chi Lin
- School of Medicine, National Yang Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan.,Department of Ophthalmology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan, 11217
| | - Jiing-Feng Lirng
- Department of Radiology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan, 11217.,School of Medicine, National Yang Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan
| | - Wan-You Guo
- Department of Radiology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan, 11217.,School of Medicine, National Yang Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan
| | - Fu-Pang Chang
- School of Medicine, National Yang Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan.,Department of Pathology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan, 11217
| | - Donald Ming-Tak Ho
- School of Medicine, National Yang Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan.,Department of Pathology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan, 11217
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Primary cutaneous malignant granular cell tumor: an immunohistochemical study and review of the literature. Am J Dermatopathol 2016; 37:334-40. [PMID: 25794371 DOI: 10.1097/dad.0000000000000106] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Granular cell tumors (GCTs) are uncommon soft tissue tumors characterized by cytoplasmic granular appearance of the neoplastic cells. Malignant granular cell tumors (MGCTs) comprise less than 2% of GCTs and are mostly found in the subcutaneous soft tissues of the lower extremities, especially the thighs. Very few cases have been reported in the skin. The uncommon occurrence of cutaneous MGCTs and their histopathologic similarities with their benign counterpart make difficult the diagnosis of this particular malignancy. We describe a primary cutaneous MGCT that presented as a left posterior chest wall mass in a 51-year-old woman. Local excision was performed for the primary tumor, which was first interpreted as an atypical GCT, but 3 months later a left axillary mass appeared, and subsequent axillary lymph node dissection demonstrated metastatic disease in 4 of 12 excised lymph nodes. We report the immunophenotype of this primary cutaneous MGCT, which was studied with an ample panel of antibodies and compare our results with those of the few previously reported cases in the skin and subcutaneous soft tissues.
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12
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Orbital granular cell tumours: clinical and pathologic characteristics of six cases and literature review. Eye (Lond) 2016; 30:529-37. [PMID: 26742863 DOI: 10.1038/eye.2015.268] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 11/04/2015] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To retrospectively assess the clinicopathological characteristics of orbital granular cell tumours (GCTs). METHODS A non-comparative review of the clinical characteristics, imaging, histopathological features, management, and prognosis of five cases of benign GCT and one case of malignant GCT (MGCT) was conducted, along with a review of the English language literature. RESULTS Among the six cases, four tumours were adherent to the extraocular muscle (EOM), and three tumours to the optic nerve (ON). Morphologic examinations revealed polygonal cells containing periodic-acid-Schiff-positive eosinophilic granules. All tumours (100%) were positive for VIM and NSE, five (83.3%) tumours were positive for S-100, and three (50%) tumours were positive for CD68. The follow-up examination of the MGCT witnessed recurrence and brain metastasis despite several thorough resections, but the patient remained alive; the follow-up examination of the four benign GCTs that had received incomplete excision revealed recurrence in one patient and dramatic shrinkage of the residual tumour in another; there was no recurrence in the other two patients. CONCLUSIONS GCT should be considered in the differential diagnosis of orbital tumours, which may affect EOMs and ON. The natural course of GCT can include tumour progression, stability, or spontaneous regression. To avoid recurrence, complete resection is recommended for orbital GCT. To the best of our knowledge, primary orbital MGCT is reported for the first time.
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Surgical Excision of Orbital Progressive Granular Cell Tumour. Case Rep Ophthalmol Med 2015; 2015:420490. [PMID: 26090251 PMCID: PMC4451783 DOI: 10.1155/2015/420490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 05/05/2015] [Indexed: 12/02/2022] Open
Abstract
Granular cell tumour (GCT) is mostly benign lesion first described by Abrikossoff and named after him. Most cases are reported in the head and neck area, where the tongue is the most common site. Here we review previous cases in the literature for GCT in the orbit and present a new case. A 49-year-old male presented with apparent exophthalmos. Examination of the patient revealed the presence of a mass in the bottom side of the orbit. A substantial progress was noted after two months from the initial examination using computed tomography (CT) scan. An orbital mass was extracted and histological analysis showed signs typical for GCT. Immunohistochemistry was positive for S-100; the biopsy showed no mitotic or necrotic areas. Proptosis was resolved after surgery and a six-year follow-up CT scan was performed. We conclude that rapid progress of the tumour does not necessarily suggest malignancy.
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de la Vega G, Villegas VM, Velazquez J, Barrios M, Murray TG, Elhammady MS, Sidani C. Intraorbital Granular Cell Tumor Ophthalmologic and Radiologic Findings. Neuroradiol J 2015; 28:140-4. [PMID: 25963156 DOI: 10.1177/1971400915576657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Granular cell tumor is a rare soft tissue neoplasm that commonly affects the head and neck regions. We describe a case of a granular cell tumor of the orbit including its clinical presentation, histopathology, and magnetic resonance imaging findings.
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Affiliation(s)
| | | | | | | | | | - Mohamed Samy Elhammady
- Department of Neurosurgery, University of Miami Miller School of Medicine; Miami, Florida, USA
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Kim Y, Lee SJ, Oh MJ. A Case of Granular Cell Tumor of the Orbit. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.1.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Youngdon Kim
- Department of Ophthalmology, National Medical Center, Seoul, Korea
| | - Seung Jae Lee
- Department of Ophthalmology, National Medical Center, Seoul, Korea
| | - Min Jin Oh
- Department of Ophthalmology, National Medical Center, Seoul, Korea
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Tumeur à cellules granuleuses : à propos d’une localisation vulvaire compliquée de métastases pulmonaires. Cancer Radiother 2013; 17:671-4. [DOI: 10.1016/j.canrad.2013.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 05/22/2013] [Accepted: 05/25/2013] [Indexed: 11/18/2022]
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17
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Malignant granular cell tumor of the breast: case report and literature review. Breast Cancer 2012; 22:317-23. [PMID: 22467405 DOI: 10.1007/s12282-012-0362-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Accepted: 03/12/2012] [Indexed: 12/11/2022]
Abstract
Granular cell tumors (GCTs) are uncommon soft tissue tumors that mostly occur in patients between 40 and 60 years of age and can occur at various body sites. Malignant granular cell tumors (MGCTs) comprise less than 2 % of GCTs and are mostly found on the lower extremities, especially the thighs. These tumors grow more rapidly than benign GCTs, and most importantly, they can metastasize. We describe an MGCT that presented as a right breast mass in a 79-year-old Japanese woman. Local excision was performed for the primary tumor, which was diagnosed as an atypical GCT, but 15 months later, the tumor recurred at the same site. Thereafter, right mastectomy with axillary lymph node dissection was performed. Metastatic disease was identified in 2 of 12 lymph nodes. The pathological examination revealed that the tumor had progressed to an MGCT after recurrence. Multiple liver, lung and bone metastases were revealed 4 months after the second surgery, and the patient died 34 months after the primary surgery. Our findings highlighted the difficulty in diagnosing MGCTs using histological features alone and suggested the usefulness of Ki67 values. A tumor with a high level of Ki67 should be treated as malignant, even if the tumor has few pathological features of malignancy.
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Abstract
Primary granular cell tumor of the orbit is a rare type of neoplasm. The tumor is frequently associated with extraocular muscles, and eye motility limitation is an unavoidable complication after its surgical removal. The objective of the present article is to review the literature on primary granular cell tumors of the orbit and to report a case of this uncommon neoplasia. Granular cell tumor is a benign lesion encountered in most cases (58.3%) in the inferior aspect of the orbit. Extraocular muscle involvement occurs in 72.2% of the patients, and diplopia is present in 77.1% of the cases. The inferior and medial recti are the most affected muscles (38.5% and 26.9%, respectively). Surgical excision is the only modality of treatment, but diplopia persists in 73.3% of the cases. In conclusion, granular cell tumor is a benign lesion but involves a high rate of extraocular muscle morbidity.
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Ahn JH, Seo SG, Her J. A Case of Granular Cell Tumor in Form of Ciliary Body Tumor. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2009. [DOI: 10.3341/jkos.2009.50.5.790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jae Hwan Ahn
- Department of Ophthalmology, Inje University, Pusan Paik Hospital, Busan, Korea
| | - Sung Gwan Seo
- Department of Ophthalmology, Inje University, Pusan Paik Hospital, Busan, Korea
| | - Jun Her
- Department of Ophthalmology, Inje University, Pusan Paik Hospital, Busan, Korea
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Aksoy S, Abali H, Kilickap S, Harputluoglu H, Erman M. Metastatic granular cell tumor: a case report and review of the literature. Acta Oncol 2006; 45:91-4. [PMID: 16464802 DOI: 10.1080/02841860500341132] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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21
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Golio DI, Prabhu S, Hauck EF, Esmaeli B. Surgical resection of locally advanced granular cell tumor of the orbit. J Craniofac Surg 2006; 17:594-8. [PMID: 16770206 DOI: 10.1097/00001665-200605000-00037] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We report a case of locally advanced granular cell tumor of the orbit treated by a multidisciplinary surgical approach. A 49-year-old woman with a recently biopsied granular cell tumor of the orbit was referred to our tertiary care cancer center for evaluation of a right-sided globe ptosis and a palpable mass in the right orbit that had been present for approximately two years. Magnetic resonance imaging showed a large orbital mass that extended posteriorly to the orbital apex and anteriorly to the levator and superior rectus muscle complex. A workup including computed tomography of the chest, abdomen, and pelvis did not show any metastatic foci. Surgical resection of the mass was undertaken via a frontozygomatic craniotomy supplemented by an anterior orbitotomy to repair the levator aponeurosis and the superior oblique tendon, which were partially resected with the mass. Histologic evaluation of the mass revealed solid nests of polygonal cells that had centrally located, round nuclei with abundant eosinophilic granular cytoplasm. The cytoplasmic granules were positive on the periodic acid-Schiff reaction and were diastase-resistant. Immunohistochemical staining was positive for S-100 protein. During the most recent follow-up visit six months after surgery, the patient had no clinical evidence of tumor recurrence, had minimal residual ptosis and exposure keratopathy, and had stable visual function.
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Affiliation(s)
- Dominick I Golio
- Section of Ophthalmology, University of Texas, M.D. Anderson Cancer Center, Houston, Texas 77005, USA
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Hosaka T, Suzuki S, Niikawa H, Shibuya J, Suzuki T, Handa M. A rare case of a pulmonary granular cell tumor presenting as a coin lesion. Gen Thorac Cardiovasc Surg 2003; 51:107-9. [PMID: 12691120 DOI: 10.1007/s11748-003-0082-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A 38-year-old man was found to show a well-defined oval-shaped homogeneous dense mass (20 x 30 mm) in the left upper lung field on chest X-ray. Left upper divisionectomy was performed under video-assisted thoracic surgery. Histology showed that the tumor cells had abundant eosinophilic granular cytoplasm, and were immunopositive for neuron-specific enolase, CD56, S-100 protein, and chromogranin. The proportion of Ki-67 positive cells was < 1%. An electron-microscopic examination showed many membrane-bound whorls in the cytoplasm. Although this was a very rare case presenting as an asymptomatic coin lesion, the histological features were the same as those demonstrated for granular cell tumor at common sites.
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Affiliation(s)
- Tomoko Hosaka
- Department of Surgery, Sendai Kosei Hospital, Sendai, Japan
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Sabet SJ, Tarbet KJ, Lemke BN, Smith ME, Albert DM. Granular cell tumor of the lacrimal sac and nasolacrimal duct: no invasive behavior with incomplete resection. Ophthalmology 2000; 107:1992-4. [PMID: 11054319 DOI: 10.1016/s0161-6420(00)00380-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Granular cell tumors are rare tumors of the periorbital region, and we present the second such case in the lacrimal sac. The natural history and clinical behavior of these tumors is reviewed. DESIGN Case report. METHODS The clinical presentation, workup, surgical approach, and pathology of a case of granular cell tumor of the lacrimal sac are presented. RESULTS There has been no recurrence of the lacrimal sac tumor with incomplete resection. CONCLUSIONS This case history further adds to the understanding of the biologic behavior of granular cell tumors in the periorbital region.
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Affiliation(s)
- S J Sabet
- Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, Wisconsin 53792-3220, USA
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