Tumor de células granulares de vulva: un raro tumor genital benigno / Granular cell tumor of vulva: a rare benign genital tumor

Resumen ANTECEDENTES: El tumor de células granulares de la vulva es poco común y de origen neurogénico. Afecta, principalmente, a mujeres entre 60 y 70 años y es más frecuente en la raza negra. CASO CLÍNICO: Paciente de 63 años, con una lesión vulvar indolora y no pruriginosa, en crecimiento. En la exploración se observó una lesión excrecente de 2.5 cm en la región superior del labio mayor izquierdo, dura, vascularizada y con infiltración a 2 cm de profundidad. No se palparon adenopatías sospechosas. Luego del reporte de la biopsia, sugerente de tumor de células granulares, se practicó una escisión completa, con márgenes libres. El estudio inmunohistoquímico se reportó positivo para CD68, S100 y TFE3 lo que confirmó el diagnóstico. Puesto que el índice proliferativo (Ki67) fue inferior al 5% y los márgenes quirúrgicos estaban libres, no se requirió tratamiento adyuvante. La paciente permanece en seguimiento y sin signos de recidiva. CONCLUSIÓN: Si bien los tumores de células granulares de la vulva son poco comunes y casi siempre benignos, deben incluirse en el diagnóstico diferencial de una tumoración vulvar. La inmunohistoquímica es la herramienta más útil para el diagnóstico preciso y su tratamiento de elección es la escisión local amplia, por su tendencia a la recurrencia local.

Abstract BACKGROUND: Granular cell tumor of the vulva is rare and neurogenic in origin. It mainly affects women between 60 and 70 years of age and is more frequent in black women. CLINICAL CASE: A 63-year-old woman with a painless, non-pruritic, growing vulvar lesion. Examination revealed a 2.5 cm excrescent lesion in the upper region of the left labium majus, hard, vascularized and infiltrated to a depth of 2 cm. No suspicious lymph nodes were palpated. After the biopsy report, suggestive of granular cell tumor, complete excision was performed, with free margins. The immunohistochemical study was positive for CD68, S100 and TFE3 which confirming the diagnosis. Since the proliferative index (Ki67) was less than 5% and the surgical margins were clear, adjuvant treatment was not required. The patient remains in follow-up with no signs of recurrence. CONCLUSION: Although granular cell tumors of the vulva are rare and almost always benign, they should be included in the differential diagnosis of a vulvar tumor. Immunohistochemistry is the most useful tool for accurate diagnosis and their treatment of choice is wide local excision because of their tendency for local recurrence.

Tumor de células granulares en región axilar: a propósito de un caso y revisión de la literatura / Tumor of granular cells in the axillar region: purpose of a case and literature review

Resumen El tumor de células granulares es una neoplasia infrecuente, de comportamiento biológico benigno. Por lo general, se presenta entre la cuarta y sexta década de vida como una lesión solitaria, de crecimiento lento y buen pronóstico. Su histogénesis es probablemente de origen neural siendo positivo para S-100 y Enolasa Neuronal Especifica. Se muestra un caso con una localización inusual en la región axilar, las dificultades para alcanzar el diagnóstico puesto que puede confundirse con otras neoplasias, y los elementos clínicos esenciales de este tipo de tumor.

Abstract Granular cell tumor is a rare neoplasm with benign behavior. It usually occurs in the fourth to sixth decade of life as a solitary, slow growing lesion with a good prognosis. Its histogenesis is probably of neural origin, being positive for S-100 and Neuron-Specific Enolase. We demonstrate an unusual location in the axillary region, the obstacles to reaching the diagnosis since it can be confused with other malignancies, and the essential elements for clinically suspecting benign lesions of this type.

Tumor de células granulares: a propósito de un caso / Granulle cell tumor: a case report

RESUMEN Fundamento: el mioblastoma de células granulares también conocido como tumor de Abrikossoff es una neoplasia benigna de rara frecuencia formada por células de aspecto granular. Objetivo: exponer aspectos clínicos del mioblastoma de células granulares. Presentación del caso: se reportó el caso de un paciente masculino de raza negra, 50 años de edad, que fue remitido de la Atención Primaria con impresión clínica de fibroma lingual, al examen bucal se observó lesión ovoide de 3 cm de diámetro en el dorso de la lengua, asintomática, firme, hipocoloreada, consistencia dura y bordes precisos. Se realizó exéresis mediante biopsia escisional. El diagnóstico histopatológico determinó mioblastoma de células granulares. Conclusiones: tanto las características clínicas como histológicas del tumor de células granulares son muy semejantes a otras neoplasias malignas que se asientan en la lengua como el carcinoma epidermoide por tanto su diagnóstico constituye un reto para el estomatólogo.

ABSTRACT Background: granular cell tumor known as Abrikossoff´s tumor is a benign neoplasm of rare incidence formed by cell of granular aspects. Objective: to expose clinical aspects of granular cell tumor. Case report: a clinical case is reported of a 50 years-old black male patient. He was remitted of Primary Health Service with diagnostic impression of tongue's fibroma, in the oral exam was detected an oval lesion of 3cm of diameter on dorsum of the tongue, asymptomatic, firm consistency, and well defined. The lesion was removed by excision biopsy. The histological-pathological study determined a granular cell tumor. Conclusions: both the clinical and histological characteristics of the granular cell tumor are very similar to other malignant neoplasm that settle on the tongue such as epidermoid cell carcinoma therefore its diagnosis constitutes a challenge for the dentistry.

Case for diagnosis. Dorsal nodule in a 10-year-old male

Abstract Granular cell tumors (GCTs) are rare soft-tissue neoplasms. GCT immunohistochemistry is positive for S-100, NSE, and CD68. This report describes the case of a 10-year-old male who presented with a dorsal nodule. A biopsy revealed aggregates and sheets of large epithelioid and spindle cells. The cells had abundant eosinophilic granular cytoplasm. Immunohistochemical analysis was positive for CD68, NKI/C3, and synaptophysin; weakly positive for NSE; and negative for S-100, SOX10, HMB45, Melan A, cytokeratin, SMA, EMA, and CD163. The Ki-67 index was less than 1%. A diagnosis of an S-100 negative, cutaneous, benign GCT was determined.

Tumor de célula granular em cavidade oral: relato de caso / Granular cell tumor in oral cavity: case report

Introdução: O tumor de células granulares (TCG) é uma neoplasia benigna de tecido mole incomum que acomete principalmente mulheres na quarta e sexta década de vida. A lesão possui predileção pela região de cabeça e pescoço, sendo a superfície dorsal da língua o local de maior acometimento. Clinicamente, apresenta-se como um nódulo submucoso firme, de coloração semelhante a mucosa ou levemente amarelada, de crescimento lento e assintomático. O objetivo deste trabalho é relatar um caso de TCG apresentando suas características clínicas, histopatológicas bem como os possíveis diagnósticos diferenciais. Relato de caso: Paciente sexo feminino, 46 anos de idade, apresentando nódulo localizado no bordo lateral posterior da língua. Ao exame intraoral foi possível observar tumefação firme à palpação, com coloração amarelada, medindo aproximadamente 1cm no seu maior diâmetro. Baseado na hipótese diagnóstica de lipoma, foi realizada uma biópsia excisional. A análise histopatológica revelou características morfológicas compatíveis com o TCG. Considerações finais: O Cirurgião-Dentista deve conhecer os diagnósticos diferenciais clínicos e histopatológicos, uma vez que a conduta terapêutica pode ser distinta em alguns casos... (AU)

Introduction: Granular cell tumor (GCT) is a benign neoplasm of uncommon soft tissue that mainly affects women in the fourth and sixth of life. The lesion has a predilection for the head and neck region, and the dorsal surface of the tongue is the site of major involvement. Clinically, it presents as a firm, mucosal or slightly yellowish, slowly growing, asymptomatic submucosal nodule. The objective of this work is to report a case of GCT presenting its clinical, histopathological and possible differential diagnoses. Case report: A 46-year-old female patient with a nodule located on the posterior lateral border of the tongue. On intraoral examination, it was found on a table, with a yellowish color, measuring approximately 1cm in its largest diameter. Based on the diagnostic hypothesis of lipoma, an excisional biopsy was performed. A histopathological analysis revealed morphological characteristics compatible with GCT. Final considerations: The Dentist should know the differential clinical and histopathological diagnoses, since the therapeutic behavior may be different in some cases... (AU)

Granular cell tumor of the breast: correlations between imaging and pathology findings / Tumor de células granulares da mama: correlação anatomorradiológica

Abstract Objective: To review the imaging features of granular cell tumors of the breast (on mammography, ultrasound, and magnetic resonance imaging), establishing a pathological correlation, in order to familiarize radiologists with this entity and make them aware of the differential diagnoses, other than malignancy, of lesions with spiculated margins. Materials and Methods: We reviewed the medical records (from a clinical-pathology database and picture archiving and communication system) of five patients with a pathologically confirmed diagnosis of granular cell tumor of the breast, treated at the Portuguese Oncology Institute of Lisbon, in the city of Lisbon, Portugal, between January 2012 and December 2018. Results: All five tumors exhibited imaging features highly suggestive of malignancy (BI-RADS 5 lesions), namely spiculated margins, significant depth, and posterior acoustic shadowing (on ultrasound). One tumor showed a kinetic curve indicative of washout on magnetic resonance imaging, two were adherent to the pectoralis muscle, and one was accompanied by skin retraction. Pathology provided the definitive diagnosis in all cases. Conclusion: Granular cell tumors of the breast pose a diagnostic challenge because they can present with clinical and imaging features mimicking malignancy, and the diagnosis is therefore provided by pathology. Radiologists should be familiarized with this entity, so they can be aware of the fact that breast lesions with spiculated margins can be indicative of diagnoses other than malignancy.

Resumo Objetivo: Rever as características de imagem dos tumores de células granulares da mama (mamográficas, ultrassonográficas e de ressonância magnética), estabelecendo uma correlação anatomopatológica, no intuito de proporcionar aos radiologistas uma familiarização com esta entidade e alertar para outros diagnósticos diferenciais de lesões espiculadas além das malignas. Materiais e Métodos: Consulta dos processos clínicos (base de dados clínica, anatomopatológica e sistema de comunicação e arquivamento de imagens) de doentes seguidos no Instituto Português de Oncologia de Lisboa, com diagnóstico anatomopatológico confirmado de tumor de células granulares da mama, de janeiro de 2012 a dezembro de 2018. Resultados: Todos os tumores exibiram características de imagem altamente sugestivas de malignidade (BI-RADS 5), nomeadamente espiculações, crescimento em profundidade e atenuação posterior (ultrassonografia), um mostrou um perfil cinético com washout na ressonância magnética, dois estavam aderentes ao músculo peitoral e um associava retração cutânea. O diagnóstico definitivo foi anatomopatológico. Conclusão: Os tumores de células granulares da mama constituem um desafio diagnóstico, pois podem apresentar características clínicas e de imagem que mimetizam malignidade, pelo que o diagnóstico é anatomopatológico. Os radiologistas devem estar familiarizados com esta entidade de forma a considerá-la nos diagnósticos diferenciais de lesões espiculadas, além das lesões malignas.

Granular cell tumor in female neonate: a case report / Tumor de células granulares em neonato do sexo feminino: relato de caso

ABSTRACT The granular cell tumor (GCT) is a neoplasm of connective tissue which rarely occurs in children. This case report aims to describe and discuss the presentation of this tumor in a female neonate. Compared to previous literature, the case report demonstrated a rare form of presentation of this tumor in an unusual age group.

RESUMEN O tumor de células granulares (TCG) é uma neoplasia de tecido conjuntivo que ocorre raramente em crianças. Este relato de caso descreve e discute a apresentação desse tumor em um neonato do sexo feminino. Em comparação com estudos anteriores, o caso reportado demonstrou uma forma rara de apresentação em uma faixa etária não usual.

RESUMO O tumor de células granulares (TCG) é uma neoplasia de tecido conjuntivo que ocorre raramente em crianças. Este relato de caso descreve e discute a apresentação desse tumor em um neonato do sexo feminino. Em comparação com estudos anteriores, o caso reportado demonstrou uma forma rara de apresentação em uma faixa etária não usual.

Congenital granular cell epulis: case report and differential diagnosis / Epúlide de células granulares congênita: relato de caso e diagnóstico diferencial

ABSTRACT A 16-days-old female patient exhibiting an exophytic nodular lesion located at anterior maxilla on the alveolar ridge since birth. The clinical hypothesis of congenital granular cell epulis (CGCE) was established, and the patient underwent excisional biopsy. Microscopically, a sheet-like proliferation of eosinophilic cells with granular cytoplasm was observed in a stroma of vascularized fibrous connective tissue. The immunohistochemical analysis for S100 evidenced the absence of immunostaining. The CGCE hypothesis was confirmed and, after six months, the patient showed no signs of recurrence of the lesion.

RESUMEN Niña de 16 días de edad, presentaba una lesión exofítica de aspecto nodular ubicada en la región de la cresta alveolar maxilar anterior desde su nacimiento. Se estableció la hipótesis clínica de épulis congénito de células granulares, y la paciente se sometió a una biopsia por escisión. Microscópicamente se ha observado una proliferación laminar de células eosinofílicas con citoplasma granular en medio de un estroma de tejido conectivo fibroso vascularizado. El análisis inmunohistoquímica para S100 reveló ausencia de inmunomarcación. La hipótesis de épulis congénito ha sido confirmada, y, después de seis meses, la paciente no mostró señales de recidiva de la lesión.

RESUMO Paciente do sexo feminino, 16 dias de idade, exibiu lesão exofítica de aspecto nodular localizada em região anterior do rebordo alveolar maxilar desde o nascimento. A hipótese clínica de epúlide de células granulares congênita (ECGC) foi estabelecida, e a paciente foi submetida à biópsia excisional. Microscopicamente, observou-se a proliferação em lençol de células eosinofílicas com citoplasma granular em meio a um estroma de tecido conjuntivo fibroso vascularizado. A análise imuno-histoquímica para S100 evidenciou ausência de imunomarcação. A hipótese de ECGC foi confirmada e, após seis meses, a paciente não apresentou sinais de recidiva da lesão.

Tumor de células granulares em criança: relato de caso / Granular cell tumor in a child: Case report

Introdução: O Tumor de células granulares é uma lesão, que foi descrita pela primeira vez em 1926, por Abrikosoff, ocorrendo geralmente entre a segunda e a quinta década de vida, predominantemente em mulheres negras, sendo raro o acometimento em crianças. A característica clínica é de uma lesão séssil, não sangrante, coloração da mucosa, indolor, tamanho aproximado de 1,0 cm, firme à palpação. Relato de caso: Este trabalho tem por objetivo apresentar um relato de caso de um tumor de células granulares localizado no dorso da língua de uma criança. Foi realizado excisão cirúrgica. O paciente segue em acompanhamento de 3 anos, sem recidiva. Consideracões finais: É importante relatar que o TCG é uma lesão incomum em crianças. Apresenta-se como um tumor benigno, sendo raro o aparecimento da variante maligna. Recidiva é incomum. A remoção cirúrgica é o tratamento indicado... (AU)

Introduction: Granular cell tumor is an injury that was described for the first time in 1926 by Abrikosoff, a histologically similar tumor with skeletal muscle fibers. It is suggested that this lesion originates from the skeletal muscles, this type of lesion usually occurs between the second and fifth decade of life, occurs predominantly in women and blacks, and is uncommon in children, presents as a sessile, non-bleeding, painless mucosal color lesion, approximately 1.0 cm in size, firm the palpation and the skin covering the lesion remain intact without ulcerations. Case report: Thus, this work aims to present a case report of a surgical excision of a granular cell tumor located on the back of a child's tongue after incisional biopsy and with the histopathological result confirming that it was a granular cell tumor. Surgical excision was performed under general anesthesia, where it goes through 3 years of follow-up without relapse. Final considerations: It is important to report that GCT is an uncommon injury in children. It presents as a benign tumor, being rare the appearance of the malignant variant. Relapse is uncommon. Surgical removal is the indicated treatment... (AU)

Tumor de células granulares intratiroideo / Intra-thyroid granular cell tumor

RESUMEN Fundamento: los tumores de células granulares son lesiones benignas infrecuentes de crecimiento lento que pueden aparecer en cualquier sitio del organismo. La región de cabeza y cuello incluye las localizaciones más frecuentes (entre el 30 y el 50 % de todos los tumores de este tipo, hasta los del sistema nervioso central). Objetivo: presentar un caso de tumor de células granulares intratiroideo. Caso clínico: se presenta el caso de una paciente femenina de 37 años de edad con enfermedad nodular de la glándula tiroides de crecimiento lento con escasa sintomatología, con confirmación histológica tumor de células de la granulosa. Al examen físico se identificó aumento de volumen en la región anterolateral del cuello, en relación con el lóbulo derecho de la glándula tiroidea, que correspondía con lesión tumoral de 3 cm, mal delimitada, adherida a planos profundos, no dolorosa a la palpación. En la ecografía se observó: lóbulo derecho del tiroides de 4,3 cm x 1,2 cm x 1,4 cm, no homogéneo con lesión nodular de 2,8 x 1,4 cm mal delimitada, de bordes irregulares. Se realizó biopsia transoperatoria que se reportó como positiva de células neoplásicas malignas, sin embargo, el estudio histológico extemporáneo reveló un tumor benigno de células granulares intratiroideo. El tratamiento quirúrgico es curativo en este caso. Conclusiones: el diagnóstico de tumor de células granulares intratiroideo benigno, se presenta con las características de una lesión tumoral maligna, debe tenerse en cuenta en el diagnóstico diferencial de los tumores de la glándula tiroides.

ABSTRACT Background: the granular cells tumors are uncommon benign lesions of slow growth that can appear in any place of the organism. The head and neck region includes the most frequent localizations (between the 30 and 50% of all the tumors of this type, including those of the central nervous system). Objective: to present a case of intra-thyroid granular cell tumor. Clinical case: a case of a 37 year-old female patient with nodular illness of the thyroid of slow growth with scarce symptoms, with histologic confirmation of granular cells tumor is presented. To the physical exam, an increase of volume was identified in the anterolateral region of the neck, in connection with the right lobe of the thyroid gland that corresponded with a tumoral lesion of 3cm approximately, not well defined, stuck to deep planes, not painful to the palpation. In the echography, it was observed: right lobe of the thyroid of 4.3 cm x 1.2cm x 1.4 cm, not homogeneous with a nodular lesion of 2.8 x 1.4 cm not well defined, of irregular borders. During the surgery, a frozen section was examined and reported as positive of malignancy, however, the untimely histologic study revealed a benign intra-thyroid granular cell tumor. The surgical treatment is healing in this case. Conclusions: the diagnosis of intra-thyroid benign granular cell tumor is presented with the characteristics of a malign tumor, it should be kept in mind in the differential diagnosis of the tumors of the thyroid.

S100 negative granular cell tumor of the oral cavity: dermoscopy and surgical approach

Abstract: We report the case of a 47-year-old male patient with S100 negative granular cell tumor of the oral cavity, focusing on dermoscopic features as well as surgical approach, not previously reported in the literature. The study contributes to the literature on dermoscopy and surgical treatment for this tumor and provides a practical approach to differentiating non-neural granular cell tumors and granular cell tumors.

Two cases of granular cell tumor of the breast / 中华内分泌外科杂志

To investigate the clinicopathologic features of granular cell tumor(GCT) of the breast in order to make a diagnosis and give treatment strategy of this disease.Two cases of granular cell tumor (GCT) of the breast were reported,and the clinical presentation,pathological examination and surgical procedure were analyzed.Clinical presentations were atypical,and the tumor was characterized by clear or ill-defined boundary,abundant cytoplasm,full of eosinophilic granular,and infiltrative growth.Immunohistochemical study revealed that tumor cells were positive with S-100,CD68 and vimentin but negative with cytokeratin (CK) and epithelial membrane antigen(EMA).GCT of the breast is rare,most of which is benign tumor that may be misdiagnosed as malignancy.Wide resection is the main curative treatment.The prognosis is good.The understanding of this disease should be strengthened to avoid being operated excessively.Long-term follow-up should be performed.

Rare granular cell tumor affecting a 13-year-old boy

Granular cell tumor (GCT) is a rare soft-tissue neoplasm, first described in 1926. GCT often manifests as a single, painless nodule that shows a slow enlargement in the cutaneous, subcutaneous, or submucosal tissues. It is commonly reported in adults in the third to sixth decade of life. This case report is of an incidental finding in a young boy, who was radiologically examined for orthodontic treatment purpose and found to have a radiolucent lesion in the mandible. The lesion was later diagnosed as GCT. Central GCT is rare, and the presentation in a child is even rare. Although GCT is reported to be benign, it can turn malignant in 2% of the cases and possibly metastasize too. The local recurrence within a year is characteristic for malignant GCT. The 1-year follow-up of the present case indicated no local recurrence. The case stresses the need for the frequent dental examination, specialist reference. GCT should be included in the differential diagnosis of head and neck masses, even when inside jaws. It shall be remembered that such tumors may arise in any atypical locations and there is a possibility of malignancy.

Tumor de células granulares de laringe en el niño: Caso clínico / Granular cell tumor of the larynx in the child: Case report

Los tumores de laringe son poco frecuentes en los niños. Representan el 2% de las anomalías laríngeas. El 98% son benignos; la papilomatosis respiratoria recurrente y el hemangioma son los más comunes. El tumor de células granulares, también llamado tumor de Abrikossoff, es una neoplasia benigna inusual y, más aún, en la localización laríngea. Las manifestaciones clínicas dependen del tamaño y la ubicación de la masa tumoral; el síntoma de presentación principal es la disfonía. El diagnóstico de certeza lo proporciona la biopsia. El tratamiento de elección es la cirugía. Se presenta a una niña de 9 años con disfonía y disnea de esfuerzo debidas a un tumor de células granulares laríngeo y se destaca la importancia de considerar la evaluación endoscópica de la vía aérea en todo niño con disfonía progresiva o persistente a fin de determinar la lesión causal.

Laryngeal tumors are uncommon in children, accounting only for 2% of the laryngeal anomalies. Ninety-eight percent are benign; the most frequent ones are recurrent respiratory papillomatosis and haemangioma. Granular cell tumor, also called Abrikossoff tumor, is an unusual benign neoplasm, especially in the larynx. Clinical manifestations depend on the size and location of the tumor. Dysphonia is the main presenting symptom. The diagnosis is confirmed by the biopsy. The treatment of choice is surgery. We present a 9-year-old girl with dysphonia and exertion dyspnea due to a granular cell tumor of the larynx, and we emphasize the importance of considering the endoscopic evaluation of the airway in every child with progressive or persistent dysphonia in order to determine the etiology.

Tumor de células granulares de la mama. Presentación de un caso / Granular cell tumor of the breast. Case presentation

El tumor de células granulares (TCG) es una neoplasia muy infrecuente y usualmente benigna, que afecta preferentemente a la lengua.En sólo un 6% por ciento de los casos publicados ha sido primario de la mama. Desde el punto de vista clínico e imagenológico, se plantea el diagnóstico diferencial con un carcinoma mamario invasor. Por ende, el examen anatomopatológico de muestras por punción o quirúrgicas, es crucial para establecer el diagnóstico e intentar subclasificarlo para predecir su conducta biológica. Se presenta el caso de una mujer chilena de 54 años con un TCG de la mama izquierda:(AU)

Granular cell tumor (GCT) is an uncommon and usually benign neoplasm that mostly occurs on the tongue. In only 6 percent of all published cases, GCT has been primary of the breast. From a clinical and radiological point of view, a differential diagnosis with an invasive breast carcinomais considered. Therefore, the anatomopathological examination of core biopsie or surgical samples is crucial to establish a diagnosis and tryto subclassify it in order to predict its biological behavior. We present the case of a 54-year-old chilean woman with a GCT in her left breast.(AU)

The value of color Doppler ultrasound in diagnosis and differential diagnosis of ovarian granulosa cell tumor / 中华超声影像学杂志

Objective To discuss the value of color Doppler ultrasound in the diagnosis and differential diagnosis of ovarian granulosa cell tumor (OGCT) . Methods Fourteen cases were diagnosed as OGCT by pathology postoperatively had been examined by color Doppler ultrasound check-up before the surgery . In image appearance ,the tumors were divided into cystic mass ,solid mass or mixed cystic-solid mass respectively according to their own pathological features . Additionally ,the blood flowing signal of OGCT was labeled from 0 to 3 grade with Adler standard based on the blood flowing imaging observed by color Doppler flow imaging ( CDFI) . The CDFI results were compared with the pathological diagnosis . Results Ultrasound image appearance of OGCT varied in the 14 cases .Two of them could be characterized as cystic mass ,5 solid mass and 7 mixed cystic-solid mass . The mixed cystic-solid OGCT contained solid mass in multiple cystic degeneration area . There was a significant difference in the diameter among three kinds of OGCT ( P = 0 .0006) . The more visible cystic lesion indicated the longer diameter of OGCT . According to the CDFI ,4 ,5 ,3 and 2 cases were 0 ,1 ,2 ,3 grade respectively in Adler standard . No significant difference was found among the four standards groups ( P =0 .056) . The localization diagnosis accordance rate of the Doppler imaging in OGCT was 71 .4％ (10/14) and the qualitative diagnosis accordance rate was 35 .7％ (5/14) . Conclusions The color Doppler ultrasonography can be the first-line preoperative imaging investigation in the diagnosis and differential diagnosis of OGCT ,as well as in the long-term following after surgery . It can provide more details and evidences for the treatment and prognosis assessment of OGCT .

Perioperative nursing care of one patient with 3D type diabetes mellitus complicated with type II diabetes mellitus and the individual chest wall repair and reconstruction / 中国实用护理杂志

Objective To summarize the mammary gland granulosa cell tumor 1 case of elderly patients with diabetes perioperative nursing methods chest wall reconstruction. Methods For this disease characteristics, and the patient′s individual situation to develop nursing measures, including giving surgery patients perioperative care, diabetes care, skin flap of the observation and nursing care, chest wall defect reconstruction, through intraoperative nursing with 3 d technology, psychological nursing, function exercise, active intervention. Results Through nursing, this example patient recovery smoothly, fine discharged from hospital. Conclusions In view of the patient's condition and an individual case, to develop nursing measures, improve the preoperative postoperative nursing is the key to the successful operation and patient recovery.

Endoscopic submucosal dissection in treatment of esophageal granular cell tumor: A report of 2 cases and literature review / 吉林大学学报(医学版)

Objective:To report two cases of esophageal granular cell tumor treated by endoscopic submucosal dissection,and to improve the clinical awareness of the disease.Methods:The results of endoscope and ultrasonography endoscope of 2 cases were retrospectively analyzed.A preliminary diagnosis of the 2 cases was esophageal submucosal protruded lesion.The patients underwent endoscopic submucosal dissection and the tumors were removed completely.Firstly,the lesion border was marked and then hyaluronic acid was injected into submucosa to uplift the lesion sufficiently.Secondly,the mucosa was circumferentially incised along the marked points,and then the lesion was dissected along the submucosal layer gradually to the whole.Finally,necessary hemostatic was undertaken and the wound was clipped with titanium.Results:The pathological results after operation represented that the cells were polygonal or fusiform,rich in cytoplasm and had a dichromatic granular substance,and the nuclei were small.The immunohistochemical results showed S-100 (+),NSE (+) / (-),CK (-),SMA (-),CD117 (-),desmin (-) and proved that 2 cases of tumors were esophageal granular cell tumor.Two patients recovered smoothly after operation.They underwent endoscopic examination 16 months after operation,and no local recurrence or metastasis was founded.Conclusion:Endoscopic submucosal dissection is a safe and effective treatment of esophageal granular cell tumor,and the postoperative prognosis is good.

Endoscopic submucosal dissection in treatment of esophageal granular cell tumor: A report of 2 cases and literature review / 吉林大学学报(医学版)

Objective:To report two cases of esophageal granular cell tumor treated by endoscopic submucosal dissection,and to improve the clinical awareness of the disease.Methods:The results of endoscope and ultrasonography endoscope of 2 cases were retrospectively analyzed.A preliminary diagnosis of the 2 cases was esophageal submucosal protruded lesion.The patients underwent endoscopic submucosal dissection and the tumors were removed completely.Firstly,the lesion border was marked and then hyaluronic acid was injected into submucosa to uplift the lesion sufficiently.Secondly,the mucosa was circumferentially incised along the marked points,and then the lesion was dissected along the submucosal layer gradually to the whole.Finally,necessary hemostatic was undertaken and the wound was clipped with titanium.Results:The pathological results after operation represented that the cells were polygonal or fusiform,rich in cytoplasm and had a dichromatic granular substance,and the nuclei were small.The immunohistochemical results showed S-100 (+),NSE (+) / (-),CK (-),SMA (-),CD117 (-),desmin (-) and proved that 2 cases of tumors were esophageal granular cell tumor.Two patients recovered smoothly after operation.They underwent endoscopic examination 16 months after operation,and no local recurrence or metastasis was founded.Conclusion:Endoscopic submucosal dissection is a safe and effective treatment of esophageal granular cell tumor,and the postoperative prognosis is good.

Newly Arising Contralateral Granular Cell Tumor after Wide Excision of Large Breast Granular Cell Tumor: A Case Report

Granular cell tumor (GCT) of the breast is a rare neoplasm that is usually benign in nature. The results of physical examination and ultrasonographic findings of GCT of the breast often mimic those of other malignancies. A 46-year-old woman underwent wide excision for removal of a large mass in the left breast (about 10 cm in diameter). The pathologic finding of the excised mass was benign GCT. A year after initial surgery, recurrence of the left breast mass was found along with a newly developed mass in the contralateral right breast, which was excised. In this study, we describe the case of a newly developed GCT in the contralateral breast 1 year after excision of a larger breast GCT.