Recurrent granular cell tumor: How to treat
Department of IInd Plastic and Reconstructive Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.Journal of Craniofacial Surgery (Impact Factor: 0.68). 10/2007; 18(5):1187-9. DOI: 10.1097/scs.0b013e3181572663
Granular cell tumor is an uncommon lesion usually located in the head and neck region (50%) with a female sex predominance. It is believed to be of primitive neuroectodermal origin. Typical clinical presentation is a small, uninflamed, slowly growing, yellowish mass approximately 2 cm in diameter. Granular cell tumor has a peculiar clinical behavior ranging from clearly benign, locally aggressive, or manifestly malignant. Treatment is surgical excision, but recurrences are possible. In this article, we present a case of recurrent benign granular cell tumor with the discussion of the treatment modalities. The patient was a 16-year-old girl with a 3-year history of a painless mass on the right side of her neck. The mass was excised two times at different centers and diagnosed as granular cell tumor after the pathologic examination. The time interval between the operations and recurrences was approximately 1 year. On physical examination, a yellowish, firm, nodular mass measuring approximately 2 x 1 cm was noted. Cervical lymph nodes were evaluated with ultrasonography preoperatively to exclude metastasis and no pathologic lymph nodes were noted. The lesion was excised under local anesthesia with a 1-cm safe margin and the resulting defect was closed primarily after undermining of the wound edges. Postoperatively, the wound began to heal with a hypertrophic scar and immediate precautions were taken. Topical steroid treatment and silicone blocks were applied. Now the patient is in the sixth postoperative month and followed up every month for signs of recurrence.
- [Show abstract] [Hide abstract]
ABSTRACT: Granular cell tumour (GCT), also known as Abrikosoff's tumour, is a rare neuroectodermal neoplasm. GCT makes up 0.019-0.03% of all neoplasms, and it most commonly appears in black women aged 40-60. GCT may appear anywhere on the body, but the most common locations are soft tissues of the head and neck, which constitute over a half of the cases. In most cases the tumour is benign. The authors present a very rare case of GCT in the gastrocnemius muscle. Gross examination of cells with abundant eosinophilic cytoplasm, prominent granulation and positive immunochemistry for S-100 protein confirmed the diagnosis of GCT in the described case. Eight months after radical surgery of the lesion there were no features of local recurrence. It could be assumed that the first-choice treatment of GCT is surgery of the lesion with a wide margin of healthy tissues. One of the factors that could have triggered neoplastic transformation was a trauma that took place a few months before the tumour appeared.
Article: Picture of the month