Cutaneous granular cell tumor: case report

Background: Granular cell tumor (Abrikossoff’s tumor) is a rare and slow-growing tumor of the soft tissue. Originated from the Schwann cells, it is often a benign tumor, but it can be malignant in 1-3% of the cases. Malignant cases can cause significant morbidity and mortality. It may develop in many anatomic locations, especially in the head and neck region, and also in skin and subcutaneous tissue. Case Presentation: The patient was a 27 years old female who was referred to the Imam-Reza Hospital of Birjand because of a subcutaneous mass in the left inguinal region. The tumor was appeared six months ago as a painless slow-growing nodule. In physical examination, there was a 3×4 cm subcutaneous tumor in the left inguinal region. The tumor was attached to the skin but not to the deep and surrounding tissues. There was not any evidence of lymphadenopathy or distant metastasis.  The patient was admitted in September 2017. The tumor was excised surgically with a one cm safe margin. The post-operative course was uneventful. In histopathology examination, there was a non-encapsulated neoplasm containing polygonal cells with round to oval nuclei and abundant fine pas-positive granules in the eosinophilic cytoplasm. There were fibrous bands between the tumoral cells. Overlying epithelium shows foci of pseudoepitheliomatous hyperplasia. This finding was compatible with granular cell tumor. Immunohistochemistry (IHC) staining of the cytoplasm and the nucleus for s-100 protein and cytoplasm for CD68 was also positive. The patient is symptom-free and without any sign of local recurrence or distant metastasis for 1.5 years post-operation. Conclusion: Although it’s a rare tumor, the granular cell tumor must be considered in the differential diagnosis of soft tissue tumors. Surgical excision with a safe margin is the treatment of choice for the tumor. It is recommended that the patients must be observed for two years postoperatively.