Adjuvant radiation therapy for malignant Abrikossoff’s tumor: a case report about a femoral triangle localisation

Abstract

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.

Malignant granular cell tumor of the lumbar region – a case report and review of the criteria for diagnosis

“…Wide excision margins remain the best possible option, as the role of chemotherapy or radiation therapy remains indefinite. In MGCT, adjuvant radiotherapy on the tumor bed can be delivered with the aim of reducing local recurrence risk [11]. In our case, due to R1 resection of the lesion, the patient underwent postoperative radiotherapy.…”

“…In the presented case, TFE3 was strongly positive, but no PAS/D granules were found, which helped to exclude ASPS. Moreover, the additional "neural" panel of consecutive stains was evaluated including GFAP, NF, NSE, CD56, SOX10, and Nestin; it tends to be positive in MPNST and negative in ASPS [9][10][11]. The immunohistochemical characteristics with differential diagnosis were depicted in table I.…”

Reporte de caso clínico: tumor de células granulares maligno de paladar duro

“…Se pensaba que estos tumores se originaban en las células del músculo esquelético y se las denominó "mioblastoma". [1][2][3][4][5] A pesar de que el origen de estos tumores aún es incierto, más investigaciones han sugerido que es principalmente de origen celular de Schwann. 3,7 Este tumor raro puede afectar varias regiones del cuerpo, pero se encuentra con mayor frecuencia en la cabeza y cuello que comúnmente involucra la lengua, siendo la variante maligna muy raro.…”

“…2,5 Suelen localizarse a nivel de la dermis o los tejidos subcutáneos, mucosa oral incluida la lengua, la encía, mama, vulva y tractos gastrointestinales y biliares. 2,3 Por otro lado, los tumores malignos de células granulares (TCMG) son neoplasias mesenquimatosas malignas de alto grado extremadamente raras, que representan solo el 1-2% de todos los TCG; considerándose de esta manera al presentar características citológicas malignas o cuando un tumor de apariencia benigna causa metástasis o muerte. 6 Considerándose potencialmente como mal pronóstico que las contrapartes benignas.…”

“…Los sitios comunes de metástasis son ganglios linfáticos regionales, pulmones y huesos. 1,3 Aquí reportamos un caso y revisión de la literatura se analizará la presentación, posición, diagnóstico patológico, tratamiento y pronóstico de los pacientes con tumor de células granulares maligno.…”