Granular cell tumor of the breast
A granular cell tumor (GrCT) of the breast is an uncommon, usually benign tumor which is possibly of neural origin.
On this page:
Epidemiology
They tend to occur at a younger age than other types of breast cancer 4. The age range of presentation, however, can be very variable although they occur more commonly in pre-menopausal women.
Clinical presentation
Clinically they can mimic carcinoma because of their fibrous consistency and their hardness, thus presenting as a palpable mass.
Pathology
GrCTs can occur in a variety of visceral and cutaneous sites. Most authors favor a Schwann cell origin, based on histochemical, immunohistochemical, and ultrastructural findings and on occurrence of typical lesions, within nerves.
The breast accounts of ~5-8% of all granular cell tumors 2. Cells with eosinophilic granules with abundant cytoplasm are characteristic. Positive immunohistochemical staining of the cells for S-100 protein, CD68 (KP-1) NSE, and CEA is indicative of this tumor 1. There is a negative reaction against cytokeratin.
Location
GCTs tend to occur most commonly in the upper inner quadrant corresponding to the cutaneous sensory territory of the supraclavicular nerve.
Radiographic features
Imaging features on both ultrasound and mammography can mimic that of more sinister breast malignancy.
Mammography
On mammography, these tumors can present as an ill-defined or spiculated lesions, similar to primary carcinoma.
Breast ultrasound
On ultrasound, this tumor can appear as a solid, hypoechoic, ill-defined mass, associated with a posterior shadowing, or as a well-circumscribed oval mass, associated with a posterior enhancement, depending on the extent of infiltration and degree of reactive fibrosis.
History and etymology
Granular cell tumors, in general, were first described by A I Abrikosoff in 1926 as a “myoblastic myoma” 8.
Treatment and prognosis
Usually, a wide local surgical excision is performed. While less than 1% of tumors are malignant, local recurrences have been reported with incomplete excision.
Differential diagnosis
Considerations include:
- other forms breast malignancy
Related Radiopaedia articles
Breast imaging and pathology
- breast screening
-
mammography
- breast imaging and the technologist
- forbidden (check) areas in mammography
-
mammography views
- craniocaudal view
- mediolateral oblique view
- additional (supplementary) views
- true lateral view
- lateromedial oblique view
- late mediolateral view
- step oblique views
- spot view
- double spot compression view
- magnification view
- exaggerated craniocaudal (axillary) view
- cleavage view
- tangential views
- caudocranial view
- bullseye CC view
- rolled CC view
- elevated craniocaudal projection
- caudal cranial projection
- 20° oblique projection
- inferomedial superolateral oblique projection
- Eklund technique
- normal breast imaging examples
- digital breast tomosynthesis
- breast ultrasound
- breast ductography
- breast MRI
- breast morphology
- breast intervention
- breast pathology
- malignant lesions
-
breast cancer
- breast adenocarcinoma
- ductal breast carcinoma
- ductal carcinoma in situ (DCIS)
- invasive ductal carcinoma
- lobular breast carcinoma
- ductal breast carcinoma
- adenoid cystic carcinoma of the breast
- apocrine carcinoma of the breast
- breast cancer metastases
- breast lymphoma
- breast sarcoma
- inflammatory carcinoma of breast
- intracystic breast cancer
- male breast cancer
- malignant phyllodes tumor
- metastases to the breast
- metaplastic carcinoma the breast
- gamuts
- breast adenocarcinoma
-
breast cancer
- borderline breast disease / high risk breast lesion
- benign lesions
- adenosis of the breast
- benign papillary lesions of the breast
- breast cyst
- breast hematoma
- breast hamartoma
- breast lipoma
- ductal adenoma of the breast
- epidermal inclusion cysts of the breast
- fat necrosis of the breast
- fibroadenoma
- granular cell tumor of the breast
- gynecomastia
- lymphocytic mastitis
- mammary fibromatosis
- oil cyst
- phyllodes tumor
- post-surgical breast scar
- post-radiation breast changes
- post-traumatic fibrosis
- pseudoangiomatous stromal hyperplasia (PASH)
- pseudogynecomastia
- tubular adenoma
-
breast calcifications (approach)
- morphology
- distribution
- location
- lobular calcification within breast tissue
- intraductal calcification within breast tissue
- milk of calcium within a breast cyst
- vascular calcification in breast tissue
- skin (dermal) calcification in / around breast tissue
- suture calcification within breast tissue
- stromal calcification within breast tissue
- artifactual calcification from outside the breast
- suspicious breast calcifications
- infection/inflammation
- vascular lesions
- systemic disease
- gamuts
- classification systems
- malignant lesions
- breast cancer staging