2017 Volume 56 Issue 3 Pages 149-153
Background : Granular cell tumor (GCT) is a rare, usually benign, neoplasm of the skin and soft tissue, and involves the vulva in approximately 15% of the cases.
Case : A 36-year-old female patient presented to us with the complaint of a slow-growing lump (4-cm size at presentation) on the left labium majus. We performed wide local excision of the mass. The gross specimen was a firm, solid white-yellow nodule, with no hemorrhage or necrosis. On microscopic examination, the tumor was composed of large polygonal cells with abundant granular eosinophilic cytoplasm, arranged in sheets and nests irregularly infiltrating between collagen bundles. Results of immunohistochemical staining for neural markers (neuron-specific enolase : NSE, S-100 proteins, and CD68) were positive. Touch smear of the vulvar tumor showed isolated large cells with abundant granular cytoplasm having small round or oval nuclei. Some tumor cells had nuclear grooves and showed mild nuclear atypia.
Conclusion : GCT of the vulva is a rare neoplasm of neural sheath origin. Although GCTs are mostly benign, the reported recurrence rates are about 2% with negative margins. Wide local excision is the treatment of choice and careful follow-up is recommended in patients with lesions larger than 4 to 5 cm in diameter.
