Granular cell tumor of the breast: correlations between imaging and pathology findings

Imaging Features of the Mesenchymal Tumors of the Breast according to WHO Classification: A Pictorial Essay

Mesenchymal tumors of the breast, which originate from the mammary stroma, are rare accounting for only approximately 0.5%-1% of all breast tumors. Pathologically, they can exist on a spectrum, ranging from benign to malignant. Such tumors may present with nonspecific findings on breast imaging, including mammography, ultrasound, and MRI, which can lead to diagnostic challenges. In the 2019 revised 5th edition of the World Health Organization classification, breast mesenchymal tumors are categorized into six groups. The current pictorial essay aimed to explore the clinical, pathological, and imaging characteristics of representative lesions in each category according to this six-group classification, with the ultimate goal of enhancing awareness for early diagnosis.

Breast granular cell tumor: A case report and review of literature

Granular cell tumor (GCT) is a rare neoplasm. Its diagnosis is based on imaging and pathological findings. There are only a few reported cases of GCT of the breast (GCTB) in the literature. We present a case of a female patient diagnosed with GCTB and perform a review on the prevalence, diagnosis, histology, treatment, and prognosis.

Granular Cell Tumor of the Breast: Understanding the Cancer Mimic through a Series of Three Cases

Granular cell tumors of breast are rare neoplasms, majority of which are benign. Their imaging appearances are often indistinguishable from breast cancer. They may demonstrate a few differentiating features and unlike breast cancer, typically follow a benign course. Histopathology and immunochemistry form the cornerstone of diagnosis of granular cell tumor. In this article, we presented a series of three cases of granular cell tumors with variable presentations. Our goal is to increase familiarity for these neoplasms and for the readers to be able to distinguish them from the more common entity of breast cancer, as their prognosis and management differ.

Detection of benign granular cell tumor of the breast via 18F-PSMA-PET/CT in a patient with very high-risk prostate cancer: A case report

Incidental extra-prostatic prostate-specific membrane antigen (PSMA) uptake on initial staging positron emission tomography/computed tomography (PET/CT) scans poses diagnostic challenges, as it can be associated with various benign and malignant lesions. We present the case of a 68-year-old man with very high-risk prostate cancer who was incidentally discovered to have a benign granular cell tumor in the breast initially detected on PSMA-PET/CT. Imaging studies and biopsy were pivotal in the diagnosis, as the tumor's appearance was concerning for breast carcinoma. Recognizing extra-prostatic PSMA uptake in the breast, particularly in patients with prostate cancer, is crucial for guiding appropriate management, accurately interpreting subsequent imaging findings, and assessing radiologic-pathologic correlation.

Granular cell tumour of the breast

Granular cell tumours (GCT) of the breast have similar clinical and radiological features to breast carcinomas. We present a case of a female patient with a tender, palpable lump, and associated skin changes. Imaging of the lesion was suspicious of malignancy. Initial histological examination showed uniform sheets of polygonal cells with abundant granular cytoplasm, and follow-up immunohistochemistry showed strongly positive staining of tumour cells with S100 and CD68, confirming the diagnosis of GCT. Wide local excision with complete resection margins was performed as a curative treatment for this lesion. This case report highlights the importance of considering GCTs in the differential diagnoses of breast lesions suspicious of malignancy and emphasises the necessity of accurate diagnosis of GCT for proper treatment.

The conundrum of breast cancer mimics

The BIRADS lexicon ensures a standard reporting terminology in breast imaging and serves as a means of smooth communication between the radiologist and the referring physician. BIRADS assessment categories 4 and 5 warrant a biopsy to rule out underlying malignancy. However, a substantial number of cases in these categories sometimes turn out to be benign on biopsy. These benign mimics encompass inflammatory, sclerosing, neoplastic and a few other miscellaneous conditions. Awareness of these various mimics of breast cancer can equip the radiologist to handle these apparent cases of radiologic-pathological (rad-path) discordance better, guide overall patient management, avoiding inadvertent excisional biopsies and help alleviate patient anxiety and confusion.

Case Report of a Benign Granular Cell Tumor Resembling Breast Carcinoma in a Young Woman: A Diagnostic Challenge

Introduction

Granular cell tumors (GCTs) are uncommon, low-grade Schwann cell tumors found in the skin, soft tissue, and mucosal surfaces of the oral, gastrointestinal, and respiratory tracts. One in 1,000 breast cancer cases is GCT. Just 1-2% of GCTs are malignant GCTs.

Case Presentation

This case report presents the clinical details and outcomes of a 34-year-old woman with a main concern of a palpable mass and pain in her right breast. In the clinical examination, we found a 1.5 × 2-cm palpable mass in her right breast with no axillary lymph node detection. The primary diagnosis was a benign GCT mimicking carcinoma of the breast. Upon evaluation, the mass was confirmed to be a benign GCT through pathology. The patient underwent breast-conserving surgery and sentinel lymph node dissection at the Cancer Research Center of Shahid Beheshti University of Medical Sciences on November 30, 2022. The surgical margins were found to be free of tumors, and there was no involvement of skin or axillary lymph nodes. The patient had a positive postoperative outcome, with no complications observed.

Conclusion

The case highlights the importance of accurate diagnosis and appropriate surgical planning to avoid invasive procedures and unnecessary radical surgeries in cases of benign GCT mimicking carcinoma of the breast.

Mesenchymal Tumors of the Breast: Fibroblastic/Myofibroblastic Lesions and Other Lesions

Mesenchymal breast tumors are a rare and diverse group of tumors that present some of the most challenging cases for multidisciplinary breast cancer teams. As a result of overlapping morphologies and a lack of large-scale studies on these tumors, practices are often heterogeneous and slow to evolve. Herein, we present a non-systematic review that focuses on progress, or lack thereof, in the field of mesenchymal breast tumors. We focus on tumors originating from fibroblastic/myofibroblastic cells and tumors originating from less common cellular origins (smooth muscle, neural tissue, adipose tissue, vascular tissue, etc.).

Granular Cell Tumor of the Axillary Accessory Breast: A Case Report

Granular cell tumors (GCTs) are rare benign soft tissue tumors that can occur throughout the body, particularly the head and neck; only 5%-8% of GCTs occur in the breast. We report a case of a GCT of the axillary accessory breast, which is a rare location of this tumor. A 50-year-old woman had a 2-month history of a palpable mass in the left axilla. Physical examination, as well as mammographic and ultrasonographic findings suggested a breast malignancy. Histopathological examination showed a benign GCT, and wide local excision was performed. The patient has remained disease-free over 2 years postoperatively. Although most GCTs are benign, wide complete resection of the tumor and follow-up are required considering the possibility of recurrence. The radiologist should know the characteristics of GCTs as a differential diagnosis of breast and axillary lesions to prevent unnecessary treatment.

Granular cell tumour of the breast: A case report

INTRODUCTION

Breast granular cell tumour (GCT) is a rare but usually benign lesion.

PRESENTATION OF CASE

We report a case of a woman with breast GCT.

CONCLUSION

Clinically and radiologically, GCT may mimic breast carcinoma. A conclusive diagnosis is made after a histopathological examination of the lesion. The treatment of choice is surgery.

Granular Cell Tumor Originating from the Pectoral Muscle: A Rare Extramammary Finding on Mammography

A granular cell tumor (GCT) is a rare soft tissue tumor that usually arises from the striated muscle of the tongue. Few literatures have reported pectoral muscle involvement of the GCT. Herein, we report a rare case of a GCT originating from the pectoral muscle below the breast with multimodal imaging appearance.

Abrikossoff Tumor Clinically Mimicking Carcinoma in Accessory Axillary Breast Tissue

Abrikossoff tumors are rare benign soft-tissue lesions also known as granular cell tumors (GCT). The histogenesis of these tumors was initially considered to be myogenic but recent studies have revealed a neuroectodermal origin. GCTs of the breast may mimic breast carcinoma based on the triad of radiological, clinical, and pathological features. This hallmark trait lends to the misdiagnosis of these tumors and their subsequent inappropriate management. We report a rare case of a 28-year-old female patient with an accessory axillary breast GCT. The diagnosis, histogenesis, and management of Abrikossoff tumors of the breast are discussed.

Uncommon Tumors and Uncommon Presentations of Cancer in the Breast

Purpose of review

The purpose is to present a case series of rare diagnoses and unusual presentations of breast lesions with radiologic-pathologic correlation from a major cancer center, and to review the recent literature on each entity with a focus on radiology-pathology concordance. We present our findings and experience from cases of metastatic small cell lung carcinoma to the breast, IgG-4 related breast disease, breast implant associated anaplastic large cell lymphoma, granular cell tumor, pleomorphic sarcoma, adenomyoepithelioma, post-radiation angiosarcoma, and breast carcinoma after risk-reducing total mastectomy.

Recent findings

It is essential for physicians to have knowledge of rare breast diagnoses and unusual breast disease presentations to formulate a complete differential diagnosis, recognize radiological-pathological concordance of these entities and provide appropriate patient care.

Summary

Current literature on these rare described entities exists mainly as case reports, case series and small-scale studies. By sharing our findings, we hope to educate trainees in radiology, pathology and other fields across the continuum of care in radiologic-pathologic correlation, while also augmenting the existing literature on these rare entities.

Granular Cell Tumor of the Breast: Radiologic-Pathologic Correlation

Granular cell tumor (GCT) is an uncommon neoplasm arising from perineural Schwann cells that can arise anywhere in the body and is particularly rare in the breast. Imaging typically shows an irregular, noncalcified mass with high density on mammography and intense posterior shadowing on US that mimics malignancy. Benign GCTs can be locally aggressive and invade the skin or chest wall. Core biopsy is necessary for diagnosis. Polygonal- to spindle-shaped cells with prominent cytoplasmic eosinophilic granules show S-100 and CD68 staining on immunohistochemistry and lack cytokeratin, estrogen, or progesterone expression. The vast majority of GCTs are benign, albeit locally infiltrative, tumors cured by wide local excision.