Granular cell tumor (GCT) is a rare neoplasm of the soft tissues, and <1% of all GCTs are malignant. It usually appears in the tongue and sometimes may affect the female breast. Initially, GCT was considered to be a myogenic lesion affecting female breast (myoblastoma). Actually, it is assumed as a tumor originating from perineural or putative Schwann cells of peripheral nerves or their precursors that grows in the lobular breast tissue, due to the immunohistochemical features. Here, we review the importance of differentiating between this tumor and malignant breast carcinoma. Mammographically, by ultrasound scan and clinically, this case appears to be a malignant tumor of the breast, but with a correct and precise diagnosis including histopathologic examination and immunohistochemical studies, it was correctly identified as a GCT.Case detailsWe present a case of a 52-year-old premenopausal woman. This report is of interest because of patient’s familial oncologic history and personal history of gynecologic cancer. This rare tumor of the breast and the special way to approach the tumor by local anesthesia makes it interesting to communicate.ConclusionThis is a case of interest because GCT located in the breast is very unusual and knowledge of GCT is required for the differential diagnosis with breast cancer.
Epidemiological data reveal an increase in incidence and mortality by breast cancer (BC) associated with obesity exclusively in postmenopausal women. 1 A meta-analysis revealed that Metabolic Syndrome (MetS) presence can be associated with a moderate increase in risk of developing a BC during postmenopause and a reduction in their survival. 2 There is only one study 3 about the link between MetS and pathological prognosis factors in BC, employing criteria not widely used in previous studies. The goal of our study was to investigate if tumor biology of BC in postmenopausal women with MetS at diagnosis time is more aggressive than it is in those women who do not have it.A cross sectional study was carried out in 285 Caucasian postmenopausal women with BC. Patients were included only if they had amenorrhea ≥1 year and had FSH > 40 mUI/mL, no personal history of cancer, were not receiving neoadjuvant therapy, were not receiving or had not received any hormonal therapy (HT) during the last 12 months, had not gone on a strictly restricted diet in the last 12 months, had not previously undergone abdominoplasty, did not suffer from carcinoma in situ, and signed the informed consent form.MetS was diagnosed if three or more of the following five criteria (ATP-III-NCEP) are met 4 : Waist circumference ≥88 cm in women;HDL-Co ≤ 50 mg/dL in women or those who were in treatment for this kind of lipids alteration; TG ≥ 150 mg/dL or be in treatment for this kind of lipids alteration; fasting plasma glucose ≥100 mg/dL or previously diagnosed type 2 diabetes, or to be in treatment for hyperglycemia; systolic blood pressure ≥130 mm/Hg or diastolic ≥85 mg/ Hg, or to be in treatment for previously diagnosed hypertension. Central obesity was defined by a waist circumference ≥80 cm, according to the new recommendations for European women of International Diabetes Foundation (IDF). 5 Clinical and demographic variables of women, anthropometric differences, obesity and central adiposity prevalence and prognosis tumor characteristics were compared in the two different women groups (with or without MetS). Statistical significance was established by P < 0.05. The study included 168 postmenopausal women with BC. 53.5% fulfilled MetS criteria. There no significant differences among clinical and demographic variables between both groups. Patients with MetS presented statistically higher basal glucose levels (119.6 ± 36.3 mg/ dL vs 96.2 ± 14.8 mg/dL; P = 0.00), in serum TG (165.6 ± 57.9 mg/ dL vs 92.5 ± 26.4 mg/dL; P = 0.00) and significantly lower in HDLco concentrations regarding without MetS. (50.7 ± 17.2 mg/dL vs 66.6 ± 15.5 mg/dL; P = 0.00). Most of the patients in Non-MetS group (67.9%) presented two Met criteria, while most of the patients in MetS group (68.8%) only fulfilled three MetS criteria.Several tumor characteristics are shown in Table 1. In the MetS
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