GRANULAR CELL TUMOR

By Gary M. White, MD

Granular cell tumor Courtesy Theodore Sebastian, MD


The granular cell tumor (GCT) is a rare, benign tumor that is thought to arise from Schwann cells. It occurs most characteristically on the tongue in a black person but may occur on the skin in a patient of any race. Visceral (e.g., CNS, genitourinary tract, aerodigestive tract) lesions may occur.

Clinical

The granular cell tumor is an asymptomatic growth which is usually solitary but may be multiple and has either a smooth, hyperkeratotic or verrucous surface.

Congenital Granular Cell Tumor

Congenital granular cell tumor (CGCT), first described by Neumann in 1871, is a benign soft tissue lesion of the neonate that almost always arises from the alveolar mucosa. It is also known as congenital epulis or Neumann's tumor. CGCTs are typically located on the anterior alveolar ridge of the maxilla and less frequently on the alveolar ridge of the mandible. CGCTs usually appear as pedunculated lesions with a smooth or lobular surface and have a firm, rubbery consistency. Lesions can vary from a few millimeters to up to several centimeters in diameter.

Malignant Granular Cell Tumor

Malignant transformation is extremely rare (<2% cases). It is more likely with size > 4 cm, aggressive clinical behavior, rapid growth, and ulceration.

Treatment

Surgical excision is appropriate. Wide local wide excision with clear margins is one option. Mohs surgery, or "slow-Mohs" using S100 staining seems to have a higher cure rate and is more tissue sparing.

References

An. Bras. Dermatol. vol.88 no.3 Rio de Janeiro May/June 2013
A 9-year-old girl presents with a single, asymptomatic, raised lesion over the right buttock for one and a half months. Indian Dermatol Online J. 2016 Sep-Oct; 7(5): 390–392

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