Atipik granüler hücreli tümör: olgu sunumu

Granüler hücreli tümör (GHT), nadir görülen mezenkimal bir neoplazmdır. Çoğunlukla baş-boyun bölgesinde özellikle de dilde yerleşim göstermekte olup nadiren rekürrens gösterir. Bu çalışmada 6 ay içerisinde nüks eden bir GHT olgusu sunduk. 53 yaşında erkek hastada sırtta yavaş büyüyen kitle GHT olarak rapor edilmiş olup tümörde pleomorfizim, mitoz, nekroz ve atipi mevcut değildi. Olgunun 6 aylık takibinde lezyon nüks etmiş ve tekrar eksize edilmiştir. Nüks lezyon eskisi ile aynı özelliklere sahipti ancak daha düzensiz sınırlı, etraf dokuya infiltratif görünümde ve yüksek Ki- 67 oranına (%10) sahipti. Belirsiz davranışlı kabul edilen olgumuzun 3 yıllık takiplerinde lokal-uzak yayılım saptanmadı. GHT genellikle benign gidişli stromal bir tümör olmakla beraber öngörülemeyen agresiv davranma potansiyeli nedeniyle tüm olgular takip altında tutulmalıdır.

Atypical granular cell tumour: case report

Granular cell tumour (GHT) is a rare mesenchymal neoplasm. It is mostly located in the head and neck region, especially in the tongue, and it rarely recurs. In this study, we present a case of GHT recurring within 6 months. A slow-growing mass on the back in a 53-year-old male patient was reported as GHT, and the tumour did not have pleomorphism, mitosis, necrosis or atypia. During the 6-month follow-up of the case, the lesion recurred and was excised again. The recurrent lesion had the same features as before, but with a more irregular border, infiltrative appearance to surrounding tissue, and a high Ki-67 ratio (10%). No local-distant spread was detected in the 3-year follow-up of our case, which was considered to have uncertain behaviour. Although GHT is generally a benign stromal tumour, all cases should be followed up because of its unpredictable potential for aggressive behaviour.

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  • Abrikossoff A. Ueber myome auseeheng von der quergestreifien willkurlich muskulatur. Virchows Arch Pathhol Anat 1926; 260: 215-33.
  • Cui Y, Tong SS, Zhang YH, et al. Granular cell tumor: A report of three cases and review of literature. Cancer Biomark 2018; 23: 173-8.
  • Moten AS, Movva S, von Mehren M, et al. Granular cell tumor experience at a comprehensive cancer center. J Surg Res 2018; 226: 1-7.
  • Gross VL, Lynfield Y. Multiple cutaneous granular cell tumors: a case report and review of the literature. Cutis 2002; 69: 343-6.
  • Levavi H, Sabah G, Kaplan B, et al. Granular cell tumor of the vulva: six new cases Arch Gynecol Obstet 2006; 273: 246-9.
  • Machado I, Cruz J, Lavernia J, et al.Solitary, multiple, benign, atypical, or malignant: the "Granular Cell Tumor" puzzle. Virchows Arch 2016; 468: 527-38.
  • Janouskova G, Campr V, Konkolova R, et al. Multiple granular cell tumour. J Eur Acad Dermatol Venereol, 2004; 18: 347-9.
  • Wang HX, Zhang LZ, Jin YL, e al. Female vulva granular cell tumor: report of a relapse case. Zhonghua Bing Li Xue Za Zhi 2019; 8; 48: 330-1.
  • Corso G, Di Nubila B, Ciccia A, et al. Granular cell tumor of the breast: Molecular pathology and clinical management. Breast J 2018; 24: 778-82.
  • 10.Ravich A, Stout AP, Ravich RA. Malignant granular cell myoblastoma involving the urinary bladder. Ann Surg 1945, 121: 361-72. .
  • Miracco C, Andreassi A, Laurini L, et al. Granular cell tumour with histological signs of malignancy: report of a case and comparison with 10 benign and 4 atypical cases. Br J Dermatol 1999; 141: 573-5.
  • Pérez-González YC, Pagura L, Llamas-Velasco M, et al. Primary cutaneous malignant granular cell tumor: an immunohistochemical study and review of the literature. Am J Dermatopathol 2015; 37: 334-40.
  • Akahane K, Kato K, Ogiso S, et al. Malignant granular cell tumor of the breast: case report and literature review. Breast Cancer 2015; 22: 317-23.
  • Fanburg-Smith JC, Meis-Kindblom JM, Fante R, et al. Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol 1998; 22: 779-94.