Central Granular Cell Odontogenic Tumor: A Literature Review of Cases Reported in the Last 71 Years with a New Case Report

Central granular cell odontogenic tumors(CGCOTs)are rare,benign,slowly growing odontogenic neoplasms.Due to their uncertain histogenesis,CGCOTs are still not included as a distinct entity in the WHO classification(2017)of odontogenic tumors.We report a case of CGCOT involving the right side of maxillary anterior region of a 39-year-old white female.Immunohistochemical staining showed that granular cells positively expressed CD68 and vimentin,and negatively expressed S-100 protein.Meanwhile,we searched Pub Med,Google Scholar,and Scopus databases to summary the clinico-pathological features of 51 reported cases of CGCOT.The results showed that the granular cells of 28.6%cases were immunopositive for vimentin and CD68,and odontogenic epithelial cells were positive immunoreactivity for cytokeratin.These findings reinforced the mesenchymal origin of granular cells and the odontogenic nature of epithelium islands.

Granular cell tumor of the breast:A case report and review of literature

BACKGROUND Granular cell tumor(GCT)of the breast(GCTB)is a rare neoplasm that can exhibit malignant characteristics both clinically and radiologically.This tumor can also coexist and colocalize with breast carcinoma.CASE SUMMARY We present a patient with this uncommon tumor and discuss the diagnostic and therapeutic approaches in order to further the knowledge of GCTB and prevent misdiagnosis and overtreatment.The characteristics of the tumor,methods of diagnosis,therapy and postoperative pathological outcomes were analyzed,and relevant literatures of GCTs were reviewed.The patient underwent surgery after core needle biopsy,and the excised neoplasm was sent for pathological examination.Histological analysis revealed nests of cells with abundant pink granular cytoplasm,confirming the diagnosis of GCTB.CONCLUSION As manifestations of GCT and malignancy can mimic each other,a careful histological examination is essential before major surgery.Treatment consisting of complete excision with close clinical follow-up is recommended.

Granular cell tumor of stomach: A case report and review of literature

Granular cell tumor （GCT） was described for the first time by Abrikosoff in 1926. It is a relatively rare neoplasm that may occur at many sites, but most commonly in the skin or soft tissues. The occurrence of GCT in the gastrointestinal tract is rare, accounting approximately for 8% of all tumors, among which the most common site is the esophagus, whereas gastric localization is very rare. Gastric GCTs can be solitary or, more frequently, associated with other gastrointestinal localization. Although GCTs are usually clinically and histologically benign, some malignant cases have been reported. Histologically, these tumors consist of polygonal and fusiform cells disposed in compact ＂nests＂ and immunohistochemical staining for S-100 protein supports the proposed derivation from Schwann cells. A correct preoperative diagnosis of this tumor can only be made in 50% of all patients and it is always based on endoscopic biopsy. Laparoscopic or conventional wedge resection represents the treatment of choice. In this study, the authors reported a case of a 49-year-old woman with a solitary granular cell tumor of the stomach with infiltrative pattern, successfully treated with surgical resection. A review of literature is also presented with emphasis on diagnostic criteria concerning the malignant form.

Esophageal granular cell tumors:Report of 9 cases and a literature review

Esophageal granular cell tumors(GCTs) are rare tumors of the esophagus.We evaluated the clinical and pathologic features of 9 esophageal GCT patients(5 men and 4 women) from our institute and reviewed the related disease literature.Patient age ranged from 25 to 53 years(mean:41 years).All the patients were asymptomatic or presented with non-specific symptoms.Most GCTs occurred in the distal esophagus and were less than 6 mm in diameter.Computational analysis showed that the average gray-scale endoscopic ultrasound images of esophageal GCTs were greater than that of esophageal leiomyomas.Eight patients were treated by endoscopic resection,and 1 patient underwent surgical excision.No post-therapy recurrence or metastasis developed during follow-up(mean:36.4 mo,range:1-72 mo).

Granular cell tumor of the cecum with extensive hyalinization and calcification:A case report

A granular cell tumor (GCT) is a benign neoplasm of unclear histogenesis that is generally believed to be of nerve sheath origin.GCT is not common and most often affects the tongue,skin and soft tissue,although it may occur anywhere in the body.We experienced a case of GCT that arose in the cecum of a 55-yearold man.The GCT was removed by laparoscopic resection.In addition to the tumor,endoscopic examination revealed the presence of a 5-mm-polyp in the descending colon and multiple tiny polyps in the sigmoid colon and rectum.Histological examination demonstrated a cecal tumor 1.5 cm × 1.0 cm × 0.7 cm with a hard consistency;in cut sections,mixed cells with yellowish and whitish portions were seen.The tumor was located between the mucosa and subserosa,and was composed of plump histiocyte-like tumor cells with abundant granular eosinophilic cytoplasm,which were immunoreactive for S-100 protein,vimentin,neuron-specific enolase,inhibin-α and calretinin.The tumor showed extensive hyalinization and focal dystrophic calcification.Immunohistochemical profiles did not confirm any particular cell type for the histogenetic origin of the GCT,including a nerve sheath origin.Extensive hyalinization and calcifi cation showing involution of tumor cells suggest benign clinical behavior of GCT.

Granular cell tumor of the common bile duct: A Japanese case

Granular cell tumor (GCT) of the biliary system is rare. It is reported that it occurs more commonly in young black women. We report here our seldom experience of a Japanese case in whom icterus was found as a first symptom just after a caesarean operation. A 36-year-old Japanese woman developed icterus after delivery by the Caesarean operation. A surgical operation was performed without can deny that there was a tumor-related change in a bile duct as a result of examination for various images. As a result of pathological evaluation, GCT was diagnosed. By the preoperative organization biomicroscopy result, it was not able to be attachd a right diagnosis. It was thought that this tumor, although rare, should be considered as one of the causes of biliary stenosis in the younger population.

Atypical granular cell tumor of the urinary bladder:A case report

BACKGROUND Granular cell tumor(GCT)is a neurogenic tumor mainly occurring in the head and neck.GCT in the genitourinary system is extremely rare and only sporadic cases of urinary bladder GCT have been reported.Most urinary bladder GCT cases are benign and only two malignant cases have been reported.Due to its rarity,no consensus criteria for the treatment of urinary bladder GCT are available at present.CASE SUMMARY A 62-year-old Chinese woman was found to have a urinary bladder tumor without any clinical manifestations on physical examination.Cystoscopy revealed a semispherical shaped lesion measuring approximately 4.0 cm in diameter at the junction of the left wall and roof of the bladder,which was covered with normal bladder mucosa.Computed tomography scan demonstrated a high-density lesion on the left wall of the bladder,measuring approximately 2.9 cm×2.4 cm with clear boundaries.Contrast-enhanced pelvic magnetic resonance imaging revealed a space-occupying lesion on the left wall of the bladder(non-mucosal origin/external pressure),which was preliminarily suspected to be a desmoplastic fibroma or leiomyoma.In the context of the above findings,a pre-operative diagnosis of bladder leiomyoma was made.The patient consequently underwent a laparoscopic partial cystectomy.The resected bladder mass looked yellowish and well-demarcated,measuring 4.0 cm×3.5 cm and infiltrated the muscular layer.The diagnosis of urinary bladder GCT was finally made by postoperative pathology,with positive immunohistochemical S-100 staining and negative pancytokeratin.The patient has been followed for 6 mo so far,with no tumor recurrence detected.CONCLUSION This case highlights the biological feature and differential diagnosis of urinary bladder GCT at the pathological and molecular levels.Transurethral resection of the bladder tumor and partial cystectomy are recommended in most urinary bladder GCT cases,while radical cystectomy is recommended in malignant cases.

Granular cell tumor of the urinary bladder: A case report

We reported a case of a GCT of the urinary bladder and review the literature.A 23-year-old female presented with dysuria that had lasted for the previous 6 months.MRI revealed a 3×2.5 cm global mass in the anterior wall of urinary bladder.Cystoscopy showed a semispherical tumor approximately 3 cm in diameter that was covered with normal bladder mucosa and extended from the bladder neck to the anterior wall of the bladder.The patient underwent transurethral resection of the tumor.Histological examination and immunohistochemical staining showed a granular cell tumor(GCT).There were no features suggesting a malignant phenotype.On 6 months follow-up,the patient has remained free of bladder recurrence.We recommend careful pathologic assessment for establishing the appropriate diagnosis and either a conservative or aggressive surgical treatment for benign or localized malignant GCT of the urinary bladder,respectively.

Esophageal granular cell tumor:A case report

BACKGROUND Esophageal granular cell tumor(eGCT)is a relatively rare,usually benign neoplasm of the neuroectoderm.It is derived from Schwann cells.Clinical symptoms of this disease are non-specific.However,the most common presenting symptom is dysphagia,which is mostly misdiagnosed as esophageal polyps under gastroscopy,yet it has a 2%chance of forming cancers.We report the case of a 52-year-old woman with solitary eGCT,then analysed retrospectivelyanalyze the clinical features and elucidate on the reduction of misdiagnosis and missed diagnosis.CASE SUMMARY A 52-year-old woman was diagnosed with“esophageal granulossoma”after esophagoscopy,which was mistaken for eGCT.CONCLUSION eGCT diagnosis depends on characteristic pathomorphologies and detection of the S-100 protein.Endoscopic mucosal resection is the preferred therapeutic method.

Bladder Malignant Granular Cell Tumor with EP300 Gene Mutation: A Case Report and Literature Review

Background: Malignant granular cell tumor (GCT) is extremely rare. Malignant GCT with EP300 gene mutation in the bladder has not been reported in the literature. Case Presentation: We report a special case of 45-year-old female with malignant GCT of the bladder. Pathological examination showed that the mass was 11 × 11 × 4.5 cm in size, involved in the bladder’s posterior wall. Under the microscope, the tumor cells were arranged in the shape of a nest or cord to infiltrate the bladder’s wall. The tumor cells were pleomorphic, red-stained granular within the cytoplasm, with increased nuclear/cytoplasmic ratio, vacuolar nuclei, and obvious nucleoli. The tumor cells were showed obvious nuclear atypia, and the mitosis was more than 5/50HPF. Coagulative necrosis was widely showed within the tumor. Immunohistochemistry (IHC) showed that S-100, NSE, CD68, CR, α-AT, and TFE-3 were strongly positive, and the Ki-67 proliferation index was around 15%. The next-generation high throughput sequencing indicated that EP300 gene was missense mutated (c.457A > G) with 33% mutation abundance, and genes of DPYD (c.1627A > G), ERCC1 (c.354T > C), NQO1 (c.559C > T), TPMT (c.719A > G) and XRCC1 (c.1196A > G) were polymorphic mutated. The patient died after three months of the second surgical treatment. Conclusions: We report for the first time a primary bladder malignant GCM accompanied by mutations in special driving genes such as EP300. We also conducted a comprehensive literature review and an in-depth discussion.

Investigation of basement membrane proteins in a case of granular cell ameloblastoma

Granular cell ameloblastoma is a rare,benign neoplasm of the odontogenic epithelium.A case of massive granular cell ameloblastoma in a 44-year-old Thai female is reported.Histopathological features displayed a follicular type of ameloblastoma with an accumulation of granular cells residing within the tumor follicles.After treatment by partial mandibulectomy,the patient showed a good prognosis without recurrence in a 2-year follow-up.To characterize the granular cells in ameloblastoma,we examined the expression of basement membrane（BM） proteins,including collagen type IV,laminins 1 and 5 and fibronectin using immunohistochemistry.Except for the granular cells,the tumor cells demonstrated a similar expression of BM proteins compared to follicular and plexiform ameloblastomas in our previous study,whereas the granular cells showed strong positivity to laminins 1 and 5 and fibronectin.The increased fibronectin expression in granular cells suggests a possibility of age-related transformation of granular cells in ameloblastoma.

Typical Aspects of the Granular Cell Tumor of the Oral Cavity

Granular cell tumor (GCT) is a rare neoplasm that can occur in any part of the body, but mostly they are located intraorally. Its histogenetic origin remains controversial, but it probably arises from Schwann cells and is generally benign. The tumor is typically asymptomatic and appears as a nodule, with a relatively high predilection for the tongue. This article reports a case of a 72-year-old woman treated at the Center of Oral Diagnosis of the Funda&#231&#227o Hermínio Ometto Dental School. The patient presented with an asymptomatic nodule in the dorsal surface of the tongue for approximately 4 months. The patient was submitted to an excisional biopsy and histopatological examination revealed polyhedral cells with granular aspect. The immunohistochemical staining for S-100 presented strong reactivity, confirming the diagnosis of GCT. Finally, we made a concise discussion about the pathogenesis and fundamental clinico-pathological aspects of GCT making the differential diagnosis.

Congenital Granular Cell Lesion:A Case Report

The congenital granular cell lesion is a rare disease that affects newborns. We present a case of a patient with nodular lesions that were located on the anterior part of the maxillary alveolar. The surgical resection of the one lesion and its histological and immunohistochemical study were made.

Granular Cell Tumour of Larynx— A Case Report

Granular cell tumors, also called Abrikossoff tumors, are benign, slowly growing neoplasms. They may occur anywhere in the body, but head and neck accounts to 45% - 65% of these cases. The most common site is the tongue. Larynx is relatively an uncommon location for these tumours, accounting for approximately three to 10 per cent of the reported cases. Laryngeal granular cell tumour is extremely rare accounting for only 19 reported cases under the age of 17 years. As many as 10% of patients experience multifocal synchronous or metachronous tumors. We present a rare case report of granular cell tumour of the larynx.

Granular cell tumor of the pancreas:A case report and review of literature

Granular cell tumors,also called Abrikossof's tumors,were originally described by Abrikossof A in 1926.The f irst case of a pancreatic granular cell tumor was described in 1975 and only 6 cases have been reported.We describe a case of granular cell tumor in the pancreas showing pancreatic duct obstruction.Because imaging studies showed f indings compatible with those of pancreatic carcinoma,the patient underwent distal pancreatectomy.Histological examination showed that the tumor consisted of a nested growth of large tumor cells with ample granular cytoplasm and small round nuclei.The tumor cells expressed S-100 protein and were stained with neuron-specific enolase and periodic acid-Schiff,but were negative for desmin,vimentin,and cytokeratin.The resected tumor was diagnosed as a granular cell tumor.To our knowledge,this is the seventh case of Granular cell tumor of the pancreas to be reported.

Endoscopic submucosal dissection for esophageal granular cell tumor using the clutch cutter

Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate.The shortcomings of this method are the deficiencies of fixing the knife to the target lesion,and of compressing it.These shortcomings can lead to major complications such as perforation and bleeding.To reduce the risk of complications related to ESD,we developed a new grasping type scissors forceps (Clutch Cutter,Fujifilm,Japan) which can grasp and incise the targeted tissue using an electrosurgical current.Esophagogastroduodenoscopy on a 59-year-old Japanese man revealed a 16mm esophageal submucosal nodule with central depression.Endoscopic ultrasonography demonstrated a hypoechoic solid tumor limited to the submucosa without lymph node involvement.The histologic diagnosis of the specimen obtained by biopsy was granular cell tumor.It was safely and accurately resected without unexpected incision by ESD using the CC.No delayed hemorrhage or perforation occurred.Histological examination confirmed that the granular cell tumor was completely excised with negative resection margin.We report herein a case of esophageal granular cell tumor successfully treated by an ESD technique using the CC.

Endoscopic resection of colorectal granular cell tumors

AIM: To determine the feasibility and effectiveness of endoscopic resection for the treatment of colorectal granular cell tumors(GCTs). METHODS: This was a retrospective study performed at a single institution. From January 2008 to April 2015, we examined a total of 11 lesions in 11 patients who were treated by an endoscopic procedure for colorectal GCTs in the Endoscopy Center, Zhongshan hospital of Fudan University, Shanghai, China. Either endoscopic mucosal resection or endoscopic submucosal dissection(ESD) was performed by three surgeons with expertise in endoscopic treatment. The pre- and postoperative condition and follow-up of these patients were evaluated by colonoscopy and endoscopic ultrasonography(EUS).RESULTS: Of these 11 lesions, 2 were located in the cecum, 3 were in the ileocecal junction, 5 were in the ascending colon, and 1 was in the rectum. The median maximum diameter of the tumors was 0.81 cm(range 0.4-1.2 cm). The en bloc rate was 100%, and the complete resection rate was 90.9%(10/11). postoperative pathology in one patient showed a tumor at the cauterization margin. however, during ESD, this lesion was removed en bloc, and no tumor tissue was seen in the wound. No perforations or delayed perforations were observed and emergency surgery was not required for complications. All patients were followed up to May 2015, and none had recurrence, metastasis, or complaints of discomfort.CONCLUSION: Endoscopic treatment performed by endoscopists with sufficient experience appears to be feasible and effective for colorectal GCTs.

Vulvar granular cell tumor

Granular cell tumors are rare,usually benign,soft tissue neoplasms of neural origin.They occur more often in females than males,the peak age incidence is in the fourth through fifth decades.They can occur anywhere in the body with up to 15% situated in the vulva.The commonest presentation is as an asymptomatic mass.Microscopic findings are usually sufficient,but immunohistochemistry can also be helpful in confirming the diagnosis.The vulvar tumors are benign in 98% of cases with 2% reported as malignant.In this case report we describe a woman with a granular cell tumor confirmed by biopsy who underwent excision of the mass but with focal extension to the resection margin on microscopy.Our recommendation of re-excision was declined.Since it is not uncommon with these tumors to find groups of tumor cells extending beyond the macroscopic limits of growth,we conclude that it is advisable to have margins assessed intraoperatively by frozen section such that further excision can be performed for positive margins.Our patient has been followed for 18 mo without recurrence,should the tumor recur,re-excision,with frozen section control,is indicated.Recurrence rates are reported as 2%-8% with clear margins and 20% with positive margins.

Esophageal granular cell tumors: Case report and literature review

We reported 5 cases of granular cell tumors(GCTs) of esophagus and reviewed the literature. There were 4 females and 1 male with a median age of 43 years and an average age of 44 years. All of the cases had solitary tumors. Tumor size was 0.4-2.5 cm in diameter. Gastroscopy revealed that 2 cases were located in the middle esophagus, 1 case in the upper esophagus, and 2 cases in the distal one. Five cases displayed graywhite, pink, yellow mucosal uplifts of esophagus, 3 cases had smooth surface, 1 case was slightly concave, and the biggest tumor had erosion. Tumor cells were large and polygonal with rich granular and eosinophilic cytoplasm, and small oval nuclei. Cells were arranged in nest or aciniform. Immunohistochemistry and histochemistry staining showed S-100+, neuron specific enolase+, Vim+, CD68+, smooth muscle actin-, Des-, CK-, CD117-, CD34-, Ki67-or ≤ 5%+. Periodic acidSchiff reaction and epithelial membrane antigen were both weakly positive. GCTs of esophagus are rare and most of the cases have good prognosis.

Granular Cell Tumor of the Esophagus: A Patient Treated by Endoscopic Mucosal Resection with Long Term Follow-Up

Granular cell tumors (GCTs) of the esophagus are uncommon. We report a case of granular cell tumor of esophagus treated by endoscopic mucosal resection (EMR) with long term follow-up.