Multiple granular cell myoblastomas in a child.
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In two cases of basal cell carcinoma with prominent granular cell features, light microscopic examination showed a tumor with the general configuration of a nodular basal cell carcinoma. Focally, there were masses of cells with eosinophilic, granular cytoplasm and large cytoplasmic inclusions, strongly suggestive of granular cell myoblastoma. Ultrastructural observations in one case showed numerous lysosome-like organelles that were similar to those described for granular cell myoblastoma, but were identical to those described for the granular cell variant of ameloblastoma, a tumor that frequently resembles basal cell carcinoma. Additional features included tonofilaments and desmosomes, both of which support an epithelial origin for the granular cells in this rare variant of basal cell carcinoma.
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The granular cell myoblastoma (granular cell tumor) is a rare lesion of mesodermal origin that occurs in many areas of the body, including the vulva in seven percent of cases. The exact origin of this tumor is still being investigated. However, nerve cell origin is generally accepted. Lesions of the vulva occur in any age group and must be biopsied to rule out carcinoma, hidradenomas, sebaceous cysts, and papillomas. The recurrence rate of incompletely excised lesions is 25 percent. The microscopic picture of the lesion may simulate carcinoma as a result of reactive hyperplasia of the overlying epidermis. Discovery of a mass on the vulva in any patient which on biopsy reveals a granular cell myoblastoma should lead the examiner to excise the lesion completely and also to search for other lesions at various sites of the body.
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In a 64-yr-old Japanese man, granular cell tumor of the stomach plus two early gastric carcinomas were detected. The granular cell tumor was a 1.5 x 1.5-cm submucosal nodule located in the posterior wall of the fundus. The mucosa adjacent to the granular cell tumor showed two well-differentiated adenocarcinomas restricted to the mucosa, but there was no continuity among these three conditions. This seems to be the first report of this type of association. Immunohistochemical study revealed S-100 protein in the component cells of the granular cell tumor, thereby supporting the proposal that this granular cell is derived from Schwann cells.
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Two adult males with cutaneous granular cell myoblastoma, localized on the leg and pubic area, are described. Atypical localizations of Abrikossoff's tumor are reviewed pointing out that the upper trunk is the most frequent of these localizations. Histopathogenesis of that tumour is also considered.
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