Colonic Granular Cell Tumor: An Endoscopic and Histopathologic Review with Case Illustration

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.

A rare case of malignant granular cell tumor of the cheek in a 16-year-old child: a case report

Introduction and importance

Granular cell tumors (GCTs) are uncommon soft tissue tumors, predominantly benign lesions. Approximately 50% occur in the tongue, with a peak incidence in the fifth and sixth decades of life. However, in this case, a rare presentation of GCTs on the cheek of a 16-year-old young female, including a review of the literature.

Methods

The medical records and histopathological slides of the case were retrospectively reviewed. This work has been reported based on Surgical CAse REport (SCARE) criteria.

Case presentation

A 16-year-old female presented with a non-painful exophytic and pigmented cheek lesion that is rapidly growing. A primary concern was expressed as cosmetic in nature, a biopsy of the mass was taken, and histopathological findings showed a malignant tumor, mostly consistent with GCTs. She was recommended to have a total excision of the mass. During follow-up, facial MRI findings indicate granulation tissue versus recurrent/residual tumor at the site of surgery, without any evidence of cancer metastasis or spread.

Clinical discussion

GCT is a tumor of Schwann cells, which is mostly benign with a 2% risk of malignant transformation. The peak incidence of this tumor is around the age of 50, and it is uncommon in young individuals. Clinically, GCT presents as a single, asymptomatic dermal or subcutaneous, brown-red nodule or papule, which grows slowly with diameter ranging from 0.5 to 3 cm. The definitive treatment for both benign and malignant GCTs is sufficient local excision with safe margins.

Conclusion

GCT is an extremely rare tumor, with a peak incidence of fifth and sixth decay of age, which usually appear in the tongue (50% of cases); however, in this case, we present a 16-year-old female with a cheek mass diagnosed as GCT. In short, we think that GCT should be considered as one of the differential diagnoses of solitary facial masses at young ages.

Granular Cell Tumor of the Ascending Colon

Granular cell tumor (GCT) was first described by Abrikossoff in 1926. It is a mostly benign tumor with rare malignant transformation. It is defined as a soft tissue neoplasm with abundant eosinophilic cytoplasm. The mean age of diagnosis for GCT is around 45 years. It is rare for GCT to be found in the gastrointestinal (GI) tract. Within the subset of GI tract, the colon is an extremely rare site for it to be found. Franburg-Smith histopathology criteria are used to differentiate a benign from a malignant GCT. The malignant form is aggressive with high recurrence rates after resection. Histopathology and immunohistochemical stains are used to make a definitive diagnosis. Herein, we present a rare case of an ascending colon polyp that was resected and found to be a benign GCT.

Granular Data: A Rare Submucosal Tumor of the Colon-Case Report and Review of the Literature

INTRODUCTION

Granular cellular tumors are unusual lesions that can occur in the gastrointestinal tract, where they localize most commonly to the esophagus followed by the colon.

AREAS COVERED

We report a case of a young man with a sub-epithelial lesion of the ascending colon, removed by endoscopic submucosal dissection. Histological examination revealed a granular cellular tumor without features of malignancy. We present a systematic review of the English literature evaluating granular cellular tumors of lower gastrointestinal tract.

EXPERT COMMENTARY

These tumors are usually asymptomatic and discovered incidentally during endoscopy performed for other reasons. Though their histological behavior is usually benign, 1-2% are malignant. Therefore, it is important that these lesions are excised and adequately pathologically characterized.