Granular Cell Tumor

Introduction: Granular cell tumors are rare neoplasms, which can be either benign or malignant. They are often discovered as incidental findings on imaging. Case: 34-year-old smoker, with complaints of fever, chills; malaise was found to have a posterior mediastenal mass on chest imaging. EBUS guided FNA of the mediastenal mass revealed histopathologic features consistent with benign granular cell tumor. Patient underwent thoracotomy and required right lower bi-lobectomy and re implantation of the right upper bronchus to the trachea, as mass was adherent o the right main stem bronchus. Discussion: Granular cell tumors are rare slow growing neoplasms, also known as Abrikosoff tumors, commonly present in the fourth to sixth decade of life. They are of Schwann cell origin and can involve any organ of the body. GCT’s are characterized with pathologic features of homogenous cells containing abundant eosinophilic granular cytoplasm with periodic acid Schiff (PAS) positive and diastase resistant granules. GCT’s can be classified into benign, atypical and malignant GCT’s based on the histologic criteria and Ki-67 index. For benign and atypical granular cell tumors, wide local excision with clear margins is curative. Malignant granular cell tumors often require adjuvant radiotherapy in addition to the local surgical excision.