Metastasizing Malignant Granular Cell Tumor (Abrikossoff Tumor) of the Anterior Abdominal Wall, with Prolonged Survival

Metastatic Granular Cell Tumor: A Rare Entity

Granular cell tumor, which is thought to recapitulate a Schwann cell phenotype, is a very rare neoplasm that belongs to soft tissue tumors. It can be classified as benign, atypical or malignant, based on specific histological criteria, with the majority of cases exhibiting an indolent behavior. Its biology and clinical course are poorly understood and its optimal management is yet to be defined, given the rarity of cases. Here we describe an atypical granular cell tumor in the upper middle back skin that evolved after a thirty-year indolent period. Despite complete surgical removal, the patient experienced a recurrence, both local and in the lungs, following an aggressive clinical course. Data on management of metastatic disease are extremely scarce, comprised exclusively of case reports. Therefore, we administered to the patient systemic therapy according to soft tissue sarcoma guidelines, which led to disease progression, with fatal outcome. In conclusion, recurrent and/or metastatic granular cell tumor is a rare disease that can be life-threatening, for which response to different therapies is unknown. The biologic behavior of atypical and malignant granular cell tumor is quite different from its benign counterpart, evoking soft tissue sarcomas, and its diagnosis should alert clinicians. The role of adjuvant chemotherapy and radiation therapy in this setting should be explored, to limit disease recurrence.

A Rare Case Report of Granular Cell Tumour of the Abdominal Wall and a Review of the Literature

Granular cell tumours (GCTs) are rare soft tissue tumours of neural origin. They have been reported in multiple anatomical sites. However, only 14 cases worldwide have been reported arising from the abdominal wall. While they can clinically manifest in a variety of ways, often they present as a small, slow-growing nodule with benign features. They can, however, be malignant, and in rare cases, they have been reported to metastasise. Here, we present a case of a rare abdominal wall GCT, which was managed with local excision. The purpose of this paper is to report the patient's clinical history, presentation, and surgical management, as well as to review the current literature to highlight the existence of this rare entity and the possibility that this may occur and should be considered a differential diagnosis in clinical practice.

Granular cell tumor of the abdominal wall, a case report and review of literature

Granular cell tumors (GCTs) on the abdominal wall are rare and present as a painless superficial abdominal mass. We report the case of a 73-year-old female, who presented to the family medicine practice with a painless subcutaneous anterior abdominal wall mass. Ultrasound showed a 0.9×0.5×1.3 cm³ hyperechoic solid lesion with distal shadowing within the subcutaneous tissue of the anterior abdominal wall. The X-ray did not show any calcification within the subcutaneous tissue which ruled out metastatic calcified lesions. The patient was referred to general surgery for further evaluation. A previous computed tomography (CT) revealed a nonspecific 12 mm lesion involving the skin and subcutaneous fat in the right upper quadrant of the anterior abdominal wall. The lesion was excised under local anesthesia and sent for histopathological analysis. CD68 highlighted the multitude of macrophages microscopically. Histopathology demonstrated CKAE1/AE3 was negative for any epithelial components and S100 was diffusely positive. A final diagnosis of GCT was made. On follow-up, the patient underwent excision of the scar tissue with no evidence of atypia or GCT. This case is unique due to its benign presentation and limited reported literature. Further evaluation of a painless subcutaneous lesion is imperative to rule out rare conditions and the possibility of recurrent or metastatic malignancy.

Epiglottic granular cell tumour: a case report and literature review

Granular cell tumour is a rare, benign tumour that may arise in the soft tissues of various locations. It is often asymptomatic; hence, it gets misdiagnosed as other conditions. This is a case of an asymptomatic 50-year-old male with an incidental finding of a supraglottic lesion during routine oesophagogastroscopy. Examination under general anaesthetic showed a whitish non-ulcerating exophytic lesion on the laryngeal surface of the epiglottis, sparing anterior commissure and vocal cords. Surgical excision was performed with an open supraglottic laryngectomy approach. Histopathology confirmed GCT, strongly positive for S-100 protein and weakly positive for CD68. Accurate histologic analysis is a key to identify this rare tumour among other differentials. Although benign, ongoing monitoring is advised due to risk of recurrence.