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

Abstract

Objective: To review the imaging features of granular cell tumors of the breast (on mammography, ultrasound, and magnetic resonance imaging), establishing a pathological correlation, in order to familiarize radiologists with this entity and make them aware of the differential diagnoses, other than malignancy, of lesions with spiculated margins. Materials and Methods: We reviewed the medical records (from a clinical-pathology database and picture archiving and communication system) of five patients with a pathologically confirmed diagnosis of granular cell tumor of the breast, treated at the Portuguese Oncology Institute of Lisbon, in the city of Lisbon, Portugal, between January 2012 and December 2018. Results: All five tumors exhibited imaging features highly suggestive of malignancy (BI-RADS 5 lesions), namely spiculated margins, significant depth, and posterior acoustic shadowing (on ultrasound). One tumor showed a kinetic curve indicative of washout on magnetic resonance imaging, two were adherent to the pectoralis muscle, and one was accompanied by skin retraction. Pathology provided the definitive diagnosis in all cases. Conclusion: Granular cell tumors of the breast pose a diagnostic challenge because they can present with clinical and imaging features mimicking malignancy, and the diagnosis is therefore provided by pathology. Radiologists should be familiarized with this entity, so they can be aware of the fact that breast lesions with spiculated margins can be indicative of diagnoses other than malignancy.

Abrikossoff Tumor Clinically Mimicking Carcinoma in Accessory Axillary Breast Tissue

“…Radiologically, B-GCTs have similar features to invasive carcinoma [4]. Mammographically, spiculation, irregular borders, isodensity, and stellation may be observed.…”

“…Mammographically, spiculation, irregular borders, isodensity, and stellation may be observed. On ultrasound, malignant features of the heterochronic spiculated lesion, shadowing, and irregular borders without or with peripheral vascularity may be seen [4]. MRI scan also lacks specificity in distinguishing GCTs from invasive breast lesions [4].…”

“…Abrikossoff tumors of the breast are rare benign GCTs. These lesions originate from the interlobular stroma of the breast [4][5][6]. They may present with the characteristic clinical, radiological, and pathological features similar to that of breast carcinoma.…”

“…B-GCTs account for 5-15% of GCTs [6]. However, most of these tumors are benign, and less than 1% of GCTs are found to have the histological and clinical features of malignancy [4]. B-GCTs have a high prevalence in the upper inner quadrant of the breast.…”

Granular Cell Tumor of the Breast: Clinical Presentation, Pathological Diagnosis and Treatment

“…The radiological presentation on Mammography can also mimic infiltrating breast carcinoma, although they mainly present as a wellcircumscribed mass [8,11]. Microcalcifications are not normally a feature of GCTs [12].…”