Granular Cell Tumor of The Inferior Rectus Muscle

Abstract

A 53-year-old woman complaining of vertical diplopia, presented with a localized swelling in the right lower lid. Magnetic resonance imaging studies demonstrated a relatively well-defined mass in the inferior rectus with similar signal characteristics to the muscle. Excisional biopsy of the mass revealed granular cell tumor composed of S-100 positive cells with acidophilic granular cytoplasm and a peripheral lymphocytic infiltration. Granular cell tumor, which is very rare in the orbit, should be considered in the differential diagnosis of tumors adjacent to or within the extraocular muscles, particularly in the inferior orbit.

Orbital Granular Cell Tumor in a Patient with Churg Strauss Syndrome: The Importance of Biopsy

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Orbital Granular Cell Tumor in a Patient with Churg Strauss Syndrome: The Importance of Biopsy

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Oculomotor Disturbances Due to Granular Cell Tumor

“…6,12,13,16,19 -31,33 In these patients, diplopia is a prominent symptom, found in 84.6% of the cases. 2,6,12-14,16,19 -25,27,29 -31,33 The inferior and medial rectus are the most affected muscles (38.5% 2,13,14,16,22,23,28,30,32,33 spectively) and the 2 muscles were involved in 4 cases (15.6%). 4,16,26,27 CGT growth is slow, and complete surgical removal is the treatment of choice (73.1%).…”

“…It is interesting that when diplopia was present before surgery, complete excision of the tumor did not improve eye motility in the majority of cases (73.3%). 6,12,[21][22][23]27,30,31 We found only one case of orbital malignant GCT that recurred and led to generalized metastasis. 8 Although there is some debate about whether CGT is a real entity, 34,35 most pathologists believe in a specific origin and a variety of cell types have been implicated in the histogenesis of the lesion, including myoblasts, 1,36 histiocytes, 37-39 perineurial fibroblasts, 40 and undifferentiated mesenchymal cells.…”

Orbital Granular Cell Tumor in a Patient with Churg Strauss Syndrome: The Importance of Biopsy

“……”

“……”

“……”

Oculomotor Disturbances Due to Granular Cell Tumor

“…6,12,13,16,19 -31,33 In these patients, diplopia is a prominent symptom, found in 84.6% of the cases. 2,6,12-14,16,19 -25,27,29 -31,33 The inferior and medial rectus are the most affected muscles (38.5% 2,13,14,16,22,23,28,30,32,33 spectively) and the 2 muscles were involved in 4 cases (15.6%). 4,16,26,27 CGT growth is slow, and complete surgical removal is the treatment of choice (73.1%).…”

“…It is interesting that when diplopia was present before surgery, complete excision of the tumor did not improve eye motility in the majority of cases (73.3%). 6,12,[21][22][23]27,30,31 We found only one case of orbital malignant GCT that recurred and led to generalized metastasis. 8 Although there is some debate about whether CGT is a real entity, 34,35 most pathologists believe in a specific origin and a variety of cell types have been implicated in the histogenesis of the lesion, including myoblasts, 1,36 histiocytes, 37-39 perineurial fibroblasts, 40 and undifferentiated mesenchymal cells.…”

Orbital Granular Cell Tumor in a Patient with Churg Strauss Syndrome: The Importance of Biopsy

“……”

“……”

“……”

Oculomotor Disturbances Due to Granular Cell Tumor

“…6,12,13,16,19 -31,33 In these patients, diplopia is a prominent symptom, found in 84.6% of the cases. 2,6,12-14,16,19 -25,27,29 -31,33 The inferior and medial rectus are the most affected muscles (38.5% 2,13,14,16,22,23,28,30,32,33 spectively) and the 2 muscles were involved in 4 cases (15.6%). 4,16,26,27 CGT growth is slow, and complete surgical removal is the treatment of choice (73.1%).…”

“…It is interesting that when diplopia was present before surgery, complete excision of the tumor did not improve eye motility in the majority of cases (73.3%). 6,12,[21][22][23]27,30,31 We found only one case of orbital malignant GCT that recurred and led to generalized metastasis. 8 Although there is some debate about whether CGT is a real entity, 34,35 most pathologists believe in a specific origin and a variety of cell types have been implicated in the histogenesis of the lesion, including myoblasts, 1,36 histiocytes, 37-39 perineurial fibroblasts, 40 and undifferentiated mesenchymal cells.…”