Granular cell tumor of the breast in a 17-year-old female: A case report

Juan R. Medina-Morell , Jorge I. Cheverez-Ocasio , Viviana Negron-Gonzalez , Gloria Ramos-Rivera
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Abstract

Introduction

Granular Cell Tumors (GCTs) are rare soft tissue neoplasms originating from Schwann cells, often benign but mimicking breast carcinoma clinically and radiologically.

Case presentation

A 17-year-old female with a second-degree family history of breast cancer presented with a painful left breast mass (∼3 cm) persisting for three years. Initial evaluation with fine needle aspiration (FNA) suggested a benign lipoma, but imaging reported BIRADS IV mass. Mammography revealed an ovoid mass with irregular margins, Sono-mammogram reported heterogeneous slightly lobulated mass with excentric sonolucent of 3 x 2.4 × 1.8 cm, no increased vascularity on sono-doppler and core needle biopsy confirmed a GCT, positive for S-100 and CD68. The patient was taken to the operating room for surgical excision. A 4 cm curvilinear incision was made over the left breast mass, just lateral to the nipple at the 3 o'clock position. En-bloc excision of the mass was carried out with 1 cm margins. The specimen was removed and sent for frozen section analysis that confirmed the cytological diagnosis of a granular cell tumor with clear margins. The excised mass was sent for permanent section to pathology. Final histopathology confirmed a benign GCT with free margins. Due to the infiltrative nature of the tumor, a second excision in similar fashion was required to obtain wider margins, which was uneventful. Clear margins were pursued due to the tumor's infiltrative nature and patient's family history of breast cancer, despite the low risk of recurrence with positive margins. The patient remains clinically disease-free at three-year follow-up.

Conclusion

Granular cell tumors of the breast, though benign, are often mistaken for carcinoma due to their clinical similarity. Complete excision with clear margins, which may require re-excision due to their infiltrative nature, is crucial to prevent recurrence.
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一名 17 岁女性的乳腺颗粒细胞瘤:病例报告
导读:粒细胞瘤(GCT)是一种罕见的软组织肿瘤,起源于许旺细胞,通常为良性,但在临床和影像学上可与乳腺癌相似。病例介绍一名 17 岁女性,家族二度罹患乳腺癌,因左侧乳房肿块(3 厘米)持续疼痛三年而就诊。细针穿刺术(FNA)的初步评估提示为良性脂肪瘤,但影像学检查报告为 BIRADS IV 级肿块。乳房 X 线造影显示为卵圆形肿块,边缘不规则,声像图显示为 3 x 2.4 x 1.8 厘米的异质轻微分叶状肿块,声像多普勒显示无血管增生,核心针活检证实为 GCT,S-100 和 CD68 阳性。患者被送往手术室进行手术切除。在左侧乳房肿块的乳头外侧 3 点钟位置做了一个 4 厘米的弧形切口。在 1 厘米的边缘对肿块进行了全切。切除的标本被送去进行冷冻切片分析,结果证实细胞学诊断为边缘清晰的颗粒细胞瘤。切除的肿块被送到病理科进行永久切片。最终组织病理学证实这是一个边缘游离的良性 GCT。由于肿瘤具有浸润性,需要以类似的方式进行第二次切除,以获得更宽的边缘,切除过程并不顺利。尽管边缘阳性复发风险较低,但考虑到肿瘤的浸润性和患者的乳腺癌家族史,还是选择了边缘清晰的手术。结论乳腺颗粒细胞瘤虽然是良性肿瘤,但由于临床表现相似,常常被误认为是癌症。完全切除并保留清晰的边缘(由于其浸润性,可能需要再次切除)对于预防复发至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
348
审稿时长
15 days
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