Granular cell tumour of the breast

Radswiki et al.

A granular cell tumour (GCT) of the breast is an uncommon, usually benign tumour which is possibly of neural origin.

They tend to occur at a younger age than other types of breast cancer 4. The age range of presentation, however, can be very variable although they occur more commonly in pre-menopausal women.

Clinically they can mimic carcinoma because of their fibrous consistency and their hardness, thus presenting as a palpable mass.

GCTs can occur in a variety of visceral and cutaneous sites. Most authors favour a Schwann cell origin, based on histochemical, immunohistochemical, and ultrastructural findings and on occurrence of typical lesions, within nerves.

The breast accounts of ~5-8% of all granular cell tumours 2. Cells with eosinophilic granules with abundant cytoplasm are characteristic. Positive immunohistochemical staining of the cells for S-100 protein, CD68 (KP-1) NSE, and CEA is indicative of this tumour 1. There is a negative reaction against cytokeratin.

Location

GCTs tend to occur most commonly in the upper inner quadrant corresponding to the cutaneous sensory territory of the supraclavicular nerve.

Imaging features on both ultrasound and mammography can mimic that of more sinister breast malignancy.

Mammography

On mammography, these tumours can present as an ill-defined or spiculated lesions, similar to primary carcinoma.

Breast ultrasound

On ultrasound, this tumour can appear as a solid, hypoechoic, ill-defined mass, associated with a posterior shadowing, or as a well-circumscribed oval mass, associated with a posterior enhancement, depending on the extent of infiltration and degree of reactive fibrosis.

Granular cell tumours, in general, were first described by A I Abrikosoff in 1926 as a “myoblastic myoma” 8.

Usually, a wide local surgical excision is performed. While less than 1% of tumours are malignant, local recurrences have been reported with incomplete excision.

Considerations include:

Breast imaging and pathology
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Article information

rID: 14932
System: Breast
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Granular cell tumour of breast
  • Granular cell tumours of the breast
  • Granular cell tumour (GCT) of the breast
  • GCT of breast

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