Granular cell tumor of the breast

Discussion:

Granular cell tumors were originally described by Abrikossoff in 1926 and are usually found in the mouth or skin but 6% occur in the breast. Up to 10% are multiple. Incidence < 1 in a 1000 breast masses. Occurs from 20 – 80 but around 40 years of age most common with slight preponderance in premenopausal black women.

Usually less than 30mm in size, and are most frequently found in the upper inner quadrant (supraclavicular nerve territory) followed by the axillary tail.  They are a neuroendocrine tumor of perineural or Schwann cell origin that typically express S100 and CD68 (KP-1).

At mammography -  range from a round well-circumscribed mass, to an indistinct or spiculated lesion. Microcalcifications are not usually a feature.

At ultrasound, present as solid, poorly marginated lesions with marked posterior shadowing or as more benign-appearing well-circumscribed solid masses. Lesion often have a reflective halo or are partially hyper-reflective which is due its infiltrative growth pattern.

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