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BackgroundGranular cell or Abrikossoff’s tumors are usually benign however rare malignant forms concern 1 to 3% of cases reported. Pelvic locations are exceptional.Case presentationWe report a case of a 43-years-old patient who had a benign Abrikossoff’s tumor localized in the right femoral triangle diagnosed at the biopsy. The patient underwent a surgical tumorectomy and inguinal lymph nodes resection. Histologically, the tumor showed enough criteria to give diagnosis of malignancy: nuclear pleomorphism, tumor cell spindling, vesicular nuclei with large nucleoli. Moreover, five lymph nodes were metastatic. Immunohistochemistry findings confirmed the diagnosis of granular cell tumor which is positive for S100 protein and CD68 antibodies. The mitotic index was nevertheless low with a Ki67 labeling index of 1–2%. A large surgical revision with an inguinal curage following radiotherapy were decided on oncology committee. Adjuvant radiotherapy on the tumor bed and right inguinal area of ​​50 Gy in conventional fractionation was delivered with the aim of reducing local recurrence risk. There was no recurrence on longer follow-up (10 months post radiotherapy).ConclusionsAdjuvant radiotherapy seems an appropriate therapeutic approach, even if controversial, given that some authors report effectiveness on local disease progression.

Conformal radiotherapy is a relatively new high‐precision treatment planning and delivery technique that requires much quality assurance, mostly during its implementation. Our study involved the eight centers participating in the French phase II dose escalation study with conformal radiotherapy for the cancer of the prostate. The dose escalation protocol consisted of five dose levels (66, 70, 74, 78, and 80 Gy ICRU prescription dose). The quality assurance topics examined are the following: (1) the target volume and organs at risk delineation uncertainty; (2) the planning target volume definition by means of 3D expansions; (3) the verification of the delivered dose under reference conditions and the dosimetric data used for treatment planning; (4) the development and comparison of different calculation methods for normal tissue complication probability; (5) a treatment planning and dose calculation intersite comparison; (6) a comparison and evaluation of the treatment planning data (volumes, doses, and dose–volume histograms) for the patient treatments included in the clinical study; and (7) the verification of the dose delivered to the prostate, determined by measurement of the entrance and exit doses and reconstruction of the dose in the prostate. The major intersite uncertainty of our study concerned the target volume delineation (σ>10% of the mean volume). The uncertainty due to the treatment planning and dose calculation procedure has been kept to significantly lower levels, owing to the use of a common treatment planning protocol describing the treatment modalities and the dose criteria for treatment plan evaluation.

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