Granular cell tumor of soft tissues: MR findings.

Granular cell tumors (GrCT) are histologically unique neoplasms that often manifest as painless solitary nodules located in the dermis or submucosal tissue. In this article we analyze the radiologic features of this type of tumor in five patients by magnetic resonance imaging (MRI), analyzing morphologic and signal characteristics. MR imaging findings were similar to other publications and we demonstrate low ADC values in our series.

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. Estudio clínico de 81 pacientes / Granular Cell Tumor: A Clinical Study of 81 Patients

Introducción: El tumor de células granulares (TCG) suele desarrollarse en la piel o en la mucosa oral, pero se ha descrito en muchos otros órganos. Suele ser único, pero puede ser múltiple y asociarse a otras enfermedades. Objetivos: Analizar las características clínicas de nuestros pacientes con TCG en la piel y la mucosa oral y su posible asociación con otras afecciones. Material y métodos: Estudio retrospectivo de los pacientes con TCG diagnosticados entre 1995-2019. Se revisaron las historias clínicas para obtener los siguientes datos: edad, sexo, localización, número de lesiones, diámetro, tiempo de evolución, diagnóstico clínico de sospecha, estado de los márgenes de resección, desarrollo de recidiva, tiempo de seguimiento y enfermedades asociadas. Resultados: Ochenta y un pacientes presentaron 89 TCG en la piel y la mucosa oral (43 mujeres/38 varones, edad media 40,21años). El diámetro medio fue de 1,34cm. Contabilizando los tumores extracutáneos 5 de los 81 pacientes presentaban TCG múltiple (6,2%). La edad media de los pacientes con TCG múltiple fue significativamente inferior a la de los pacientes con un único tumor (p=0,004). Solamente un paciente presentó recidiva local y ninguno desarrolló metástasis a distancia. No hemos detectado ningún caso asociado a otras enfermedades. Conclusiones: La mayoría de TCG son benignos, y a pesar de tener los márgenes afectados no suelen presentar recidivas locales. Sin embargo, hay que tener en cuenta la posibilidad de presentar TCG múltiples, tanto en la piel y en la mucosa oral como en órganos internos, especialmente en pacientes jóvenes (AU)

Introduction: Although a granular cell tumor (GCT) usually develops on the skin or oral mucosa, it has been described in many other organs. GCT typically presents as a solitary tumor, but multiple lesions can occur. It has also been described in association with other diseases. Objective: To describe the clinical characteristics of cutaneous and oral mucosal GCTs and explore potential associations with other diseases. Material and methods: Retrospective study of patients diagnosed with GCT at our hospital between 1995 and 2019. The following information was collected from the patients’ medical records: age, sex, number of GCTs, location, diameter, time to diagnosis, tentative clinical diagnosis, surgical margin status, recurrence, follow-up time, and associated diseases. Results: We detected 89 cutaneous or oral mucosal GCTs in 81 patients (43 women, 38 men) with a mean age of 40.21 years. The mean tumor diameter was 1.34cm. Five of the 81 patients (6.2%) had multiple GCTs, including noncutaneous tumors. Patients with multiple GCTs were on average younger than those with a single tumor (P=.004). There was only a single case of local recurrence and no cases of distant metastasis. None of the patients had associated diseases. Conclusions: Most GCTs are benign and local recurrence is uncommon, even in patients with positive margins. Nevertheless, the possibility of multiple tumors affecting the skin, oral mucosa, or internal organs should be borne in mind, especially in young patients (AU)

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.

Cervical esophaguectomy plus tracheal resection and free jeyuno graft as treatment of esophageal granular cell tumor. / Esofaguectomía cervical más resección traqueal e injerto de yeyuno libre como tratamiento de un tumor de células granulares esofágico.

Granular cell tumor is a very rare entity (0.03%) with controversial management, due to its low incidence and its usually benign behavior (98%). Its location in the digestive tract is unusual (3-11%), being the esophagus the most frequently affected organ, with about 400 published cases. However, the incidence in the cervical esophagus is anecdotal (20 published cases). We present a patient with an esophageal granular cell tumor that invaded trachea, thyroid and soft tissues, performing a block resection of the cervical esophagus, two tracheal rings, thyroid and prethyroid musculature. For digestive reconstruction, a free jejunum graft with microvascular anastomosis was made and tracheal reconstruction was performed using term-terminal anastomosis. The importance of the case is twofold: to contribute more casuistry, and to describe a highly complex surgical technique never indicated in this type of tumors, due to its rarely aggressive character.

Granular Cell Tumor: A Clinical Study of 81 Patients. / Tumor de células granulares. Estudio clínico de 81 pacientes.

INTRODUCTION: Although a granular cell tumor (GCT) usually develops on the skin or oral mucosa, it has been described in many other organs. GCT typically presents as a solitary tumor, but multiple lesions can occur. It has also been described in association with other diseases. OBJECTIVES: To describe the clinical characteristics of cutaneous and oral mucosal GCTs and explore potential associations with other diseases. MATERIAL AND METHODS: Retrospective study of patients diagnosed with GCT at our hospital between 1995 and 2019. The following information was collected from the patients' medical records: age, sex, number of GCTs, location, diameter, time to diagnosis, tentative clinical diagnosis, surgical margin status, recurrence, follow-up time, and associated diseases. RESULTS: We detected 89 cutaneous or oral mucosal GCTs in 81 patients (43 women, 38 men) with a mean age of 40.21 years. The mean tumor diameter was 1.34cm. Five of the 81 patients (6.2%) had multiple GCTs, including noncutaneous tumors. Patients with multiple GCTs were on average younger than those with a single tumor (P=.004). There was only a single case of local recurrence and no cases of distant metastasis. None of the patients had associated diseases. CONCLUSIONS: Most GCTs are benign and local recurrence is uncommon, even in patients with positive margins. Nevertheless, the possibility of multiple tumors affecting the skin, oral mucosa, or internal organs should be borne in mind, especially in young patients.

Lesões neurais da cavidade oral: estudo clinicopatológico de 171 casos / Neural lesions of the oral cavity: study clinicopathological of 171 cases

Lesões neurais são incomuns na região de cabeça e pescoço, especialmente na cavidade oral, representa n d o o principal grupo de lesões da cavidade oral com células fusiformes. O diagnóstico destas lesões pode ser desafiador já que podem compartilhar características clínicas e microscópicas similares , podendo ter natureza reacional ou neoplásica. O objetivo deste trabalho foi avaliar as características clínicas e microscópicas das lesões neurais diagnosticadas no Laboratório de Patologia Oral da Faculdade de Odontologia da Universidade Federal do R io d e Janeiro Brasil no período entre 1971 até 20 2 1 Os casos foram obtido s após a revisão dos arquivos da instituição e o diagnóstico final de cada caso foi confirmado pela análise microscópica . A s características clínicas e microscópicas de cada caso foram apresentadas de maneira descritiva. Cento e setenta e um a lesões neurais foram identificadas . As lesões apresentaram se principalmente como nódulos normocrômicos, assintomáticos, de consistência firme e superfície lisa, localizados na língua de mulheres com m é dia de idade de 43, 5 anos Os di agnósticos mais comuns foram hamartoma neurovascular 30,4 tumor de cé lulas granulares (1 7 %), neuroma traumático ( 1 6,4 %)%), seguidos de placa neurogênica subgemal (1 2,9 %), neuroma solitário circunscrito ( 9,9 %)%), schwannoma 7,6 e neurofibroma 5, 8 O presente e stud o provavelmente representa uma das maior es casuística s de lesões neurais da cavidade oral disponível na literatura. (AU)

Neural lesions ar e uncommon in the head and neck region, parti cularly in the oral cavity, representing the most common group of oral spindle cell lesions of the oral cavity. The diagnosis of neural lesions may be ch a llenging since it may share cli nical and micros copical fe atures, showing reactive or neoplastic nature. The aim of the present study was to evaluate the clinical and microscopical features of neural lesions diagnosed in the Oral P athology Labora tory of th e School of Dentistry of Federa l U niversity of Rio d e Jan eiro Brazil in a period between 1971 and 20 21 . The cases were obtained from the review of the files of this institution and the final diagnosis were confirmed after microsc opical evaluati on O ne hu n dred and seventy one neural lesions were identified . The lesions presented preferably as asymptomatic and normochromic nodules of tender consistency and smooth surface, located in the tongue of women with median age of 4 3, 5 year s The most com mo n diagnose s were neurovascular hamartoma 30,4 granular cell tumor (1 7 %)%), traumatic neuroma 1 6,4 and followed by subgemmal neurogenous plaque 1 2,9 %), circumscribed solitary neuroma 9,9 %)%), schwannoma ( 7,6 and neurofibroma ( 5, 8 %)%). The present study likely re p resent s one of the largest series of neural lesions of the oral cavity of the literature. (AU)

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.

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)

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 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.

[The histopathology and immunohistochemistry of granular cell tumour. A study of 12 cases with a brief historical note]. / Análisis histopatológico e inmunohistoquímico del tumor de células granulares. Estudios de 12 casos con una breve nota histórica.

INTRODUCTION AND OBJECTIVE: Granular cell tumour (GCT) is a benign neoplasm of neural/schwannian origin, usually presenting as a single asymptomatic lesion, mainly located in the dermis and subcutaneous tissue or submucosa, although multiple tumours may occur. Microscopically, GCTs are composed of large cells with abundant eosinophilic, granular cytoplasm arranged in sheets, nests, cords or trabeculae. Based on the cytological characteristics and the presence of necrosis, three types are recognized: benign, atypical and malignant. We aim to present the cytological and immunohistochemical characteristics of 12 granular cell tumours. MATERIALS AND METHODS: 12 cases of GCT were selected from the consultation files of one of the authors (COH) The paraffin embedded tissue was processed for immunostaining with S-100 protein, calretinin, CD68, α-inhibin, PGP9.5, CD57 (Leu7), CD63 (NKI / C3), Gap43 (growth-associated protein-43), SOX10, TFE-3 and Ki-67. RESULTS AND CONCLUSIONS: 6 male and 6 female patients, with an average age of 40, made up the study group. The most frequent location for the tumours was in the subcutaneous soft tissues of the arms. There were no malignant cases. All tumours were positive for S-100, CD57, SOX10, calretinin, CD68, PGP9.5, α-inhibin and TFE-3, with a low Ki-67 (1-5%). Additionally, we reported, for the first time, the positive immunoreaction to Gap43 (growth-associated protein-43) in GCT.

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)

Relato de caso: tumor de células granulares na vulva / Case report: granular cell tumor of the vulva

O Tumor de Células Granulares (TCG) é uma neoplasia benigna rara de tecidos moles de origem neural em que apenas 0,2% dos casos acometem a vulva. Neste relato, mulher, 57 anos, parda, internada com nódulo em grande lábio esquerdo, com crescimento progressivo, que surgiu há 1 ano. Negava dor local prurido, secreções e sangramento pós-menopausa. Foi submetida a retirada de linfonodo sentinela e vulvectomia. A lesão apresentou-se endurecida, pouco aderida com 5 a 6cm. A congelação apontou linfonodo e peça vulvar negativos para malignidade, além de provável hipótese diagnóstica de tumor de células granulares. O diagnóstico definitivo foi de TCG após a peça ser submetida a parafina

The Granular Cell Tumor is a rare soft tissue benign neoplasm of neural origin and it happens at the vulva in only 0,2% of the cases. In this report, woman, 57 years, brown, admitted with a nodule at left labia majora with progressive growth within 1 year . Denied local pain, itching, vaginal discharge and post-menopause bleeding. She was submitted into a sentinel node removal and vulvectomy. The lesion was hardened, not movable with 5 to 6 cm. The freezing pointed linfonode and vulvar piece negative to malignancy and a likely hypothesis of Granular Cell Tumor. The definitive diagnosis of Granular Cell Tumor was given after the piece was submitted into a paraffin wax microscopy

Tumor de células granulares bifocal em mucosa jugal / Tumor de células granulosas bifocal en mucosa bucal / Granulous cell bifocal tumor in the oral mucosa

O tumor de células granulares é uma lesão incomum que apresenta predileção pela cavidade oral, por apresentar baixa taxa de recidiva, o tratamento de escolha é a excisão cirúrgica simples. O objetivo caracterizar um caso de tumor de células granulares bifocal em mucosa jugal e explanar características clínicas e histopatológicas acerca da lesão. Relata-se o caso de uma paciente de 60 anos apresentando dois pequenos nódulos de superfície lisa em mucosa jugal, consistência fibroelástica e coloração levemente amarelada. Foi realizada a excisão cirúrgica das duas lesões a partir de uma biópsia excisional, onde microscopicamente foi observada uma neoplasia de células granulares arranjadas em ilhas, chegando ao diagnóstico de Tumor de células granulares. O diagnóstico final da lesão foi obtido a partir do exame histopatológico, visto que, a aparência clínica da lesão é inespecífica, sendo de extrema importância a realização da biópsia excisional. A paciente continua em acompanhamento há 6 meses e não demonstra recidiva da lesão(AU)

The granulosa cell tumor constitutes a rare disease that predominates in the tongue and has a low rate of recurrence, simply by surgical removal. The objective is to characterize a case of granulosa cells bifocal tumor in the oral mucosa with some clinical and histopathologic features to this injury. A 60-year-old patient presented with two small nodules in the smooth surface, consistency and slightly yellowish fibroelastic. These lesions were removed by excisional biopsy. From the microscopic point of view, it was demonstrated that there was a neoplasia with granule cells in some areas and the diagnosis was granular cell tumor. The definitive diagnosis of the lesion is obtained by histopathology, as the clinical appearance of the lesion is nonspecific, so it is very important to perform the excisional biopsy. The patient remains under follow-up for six months and shows no recurrence(AU)

El tumor de células granulosas es una enfermedad rara que predomina en la lengua y tiene una baja tasa de recurrencia; se trata mediante la extirpación quirúrgica simple. El próposito es caracterizar un caso de tumor de células granulosas bifocal en la mucosa bucal con algunas características clínicas y histopatológicas de esta lesión. Se presenta un paciente de 60 años con dos pequeños nódulos de superficie lisa, consistencia fibroelástica y ligeramente amarillento. Estas lesiones fueron extirpadas por biopsia excisional. Desde el punto de vista microscópico se demostró una neoplasia con células granulares en islas y se llegó al diagnóstico de tumor de células granulares. El diagnóstico definitivo de la lesión se obtiene de la histopatología, pues el aspecto clínico de la lesión es inespecífica, por lo que resulta muy importante la realización de la biopsia excisional. El paciente continúa bajo seguimiento durante 6 meses y no muestra la recurrencia(AU)

Granular cell tumor of anal border / Tumor de células granulares de borda anal

The objective of this report is to describe a case of granular cell tumor of the anal border and to review the most relevant topics of the literature on the subject. Ours is a female patient, 57 years old, with an asymptomatic nodule in the anal border for 2 years. Surgical excision was performed, with a histopathological diagnosis of granular cell tumor. The first description of this tumor was carried out in 1926 by Abrikossoff. The techniques of immunohistochemistry and electron microscopy allowed us to determine its origin in Schwann cells. These are rare tumors, most often diagnosed between the 4th and 6th decade of life and, in general, are benign formations - only 2% of them are malignant. These tumors can occur in any part of the body, although they are more common in the oral mucosa, dermis and subcutaneous tissue. The treatment solely by surgery has a curative effect, and its recurrence is unusual. The location in the anal/perianal area occurs even more rarely, and we found only 48 cases previously described in the literature.

O objetivo deste relato é descrever um caso de tumor de células granulares de borda anal e revisar os tópicos mais relevantes da literatura acerca do tema. Trata-se de uma paciente do sexo feminino, 57 anos, com histórico de nódulo na borda anal assintomático há 2 anos. Foi realizada ressecção cirúrgica da lesão, com diagnóstico histopatológico de tumor de células granulares. A primeira descrição deste tumor foi em 1926 por Abrikossoff. As técnicas de imunohistoquímica e de microscopia eletrônica permitiram determinar a sua origem nas células de Schwann. São tumores raros, mais frequentes entre a 4ª e 6ª década de vida e, no geral, benignos, apenas 2% são malignos. Podem ocorrer em qualquer parte do corpo, embora sejam mais comuns na mucosa bucal, derme e tecido celular subcutâneo. O tratamento cirúrgico isolado é curativo e a recorrência incomum. A localização no ânus/canal anal/perianal é ainda mais rara, sendo encontrados apenas 48 casos previamente descritos na literatura.

Granular cell tumor of rectal submucosa: case report / Tumor de células granulares da submucosa rectal: relato de caso

This is a case report of granular cell tumor of rectal submucosa in a female, 35-years-old patient complaining of hematochezia. We describe the histological and immunohistochemical features of the lesion responsible by this clinical find. Following that, we present a discussion of the case based on the literature review, which allowed to proving the infrequency of the tumor in the rectal area and confirms the benign nature of the tumor in this case. (AU)

Este artigo relata o caso de um tumor de células granulares da submocosa retal, em paciente de 35 anos, com queixa de hematoquezia. Fazemos a descrição dos achados histológicos e imuno-histoquímicos da lesão. Além disso, apresenta-se uma discussão do caso com base na revisão da literatura, que permitiu comprovar a infrequência do tumor na região retal e corroborar a benignidade do tumor no presente caso. (AU)