Author: Vargiamidou A.; Maurice Y.; Clark A.; Killeen D.; Holland M.; Poonawala S.
Abstract: Granular cell tumours are rare tumours arising from Schwann cells of peripheral nerves.
Approximately 5 to 15% of all granular cell tumours arise in the breast. The tumour most commonly presents in premenopausal woman and can arise anywhere in the breast parenchyma, axillary tail or subcutaneous tissue. The tumour most frequently occurs in the inner quadrant corresponding to the supraclavicular nerve distribution. Clinically, it can present as a firm, painless mass with elastic consistency which may or may not be fixed to the underlying muscle wall. Radiological presentation of the tumour is variable. It can present as an irregular, spiculate stellate mass with no associated calcifications in a mammogram. Ultrasound and dynamic MR mammography presentations can be equally misleading. Histologically the tumour consists of solid nests of polygonal or spindle cells with abundant eosinophilic granular cytoplasm, prominent nucleoli and moderate cellular atypia. Immunohistochemically the tumour is positive for S100 given its Schwann cell
origin. as well as CD68 positive. The tumour is negative for cytokeratins, MelanA and HMB45. Case Presentation: A 53 year old was invited for further imaging and evaluation of a suspicious mass in her left breast. Further radiological investigations pointed to a malignant diagnosis (U5 M5). Core biopsy of the lesion identified a granular cell tumour of the breast. Conclusion: Granular cell tumours of the breast are rare tumours that can easily be mistaken for malignancy clinically and radiologically. This case highlights the
diagnostic difficulty of granular cell tumour of the breast.
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