Case for Diagnosis
Primitive Polypoid Granular Cell Tumor
Tumor primitivo polipoide de células granulares
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"apellidos" => "Luján" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Complejo Hospitalario Universitario Insular — Materno Infantil, Las Palmas de Gran Canaria, Las Palmas, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Complejo Hospitalario Universitario Insular — Materno Infantil, Las Palmas de Gran Canaria, Las Palmas, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tumor primitivo polipoide de células granulares" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1254 "Ancho" => 1674 "Tamanyo" => 207367 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pink exophytic lesion on the outer canthus of the right eye.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">An 84-year-old man with considerable actinic damage was seen for a painless tumor on the face that had appeared several years earlier had progressively increased in size. The growth of the lesion had accelerated in the months preceding the consultation.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">Examination of the skin revealed a pink exophytic tumor (2.5 × 2 cm) on the outer canthus of the right eye, with a smooth surface, firm consistency, and slightly infiltrated neat borders (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Histopathology</span><p id="par0015" class="elsevierStylePara elsevierViewall">Histology revealed a well-defined dermal tumor with a polypoid appearance (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) consisting of large cells of varied shape with abundant eosinophilic cytoplasm containing granules, nuclear pleomorphism, and some mitotic figures (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Immunohistochemistry showed intense reactivity to CD10 and CD68 and was negative for S-100, MelanA, HMB45, and markers of neural, epithelial, and muscular differentiation.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">What Is Your Diagnosis?</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Diagnosis</span><p id="par0025" class="elsevierStylePara elsevierViewall">Primitive polypoid granule cell tumor.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Clinical Course and Treatment</span><p id="par0030" class="elsevierStylePara elsevierViewall">The tumor was fully excised and the patient has shown no signs of recurrence or metastasis after 1 year of follow-up.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Comment</span><p id="par0035" class="elsevierStylePara elsevierViewall">Primitive polypoid granular cell tumor is a rare tumor of uncertain lineage that was first described by Le Boit et al in 1991.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> There are very few published cases in the literature, and both sexes appear to be equally affected.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Most cases present before 50 years of age and the most common location is the trunk, followed by the extremities and the head and neck. The tumor is painless and of variable size.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Unlike conventional granular cell tumor, it is characterized by neater borders, negative S-100 immunostaining, and more concerning cytological findings with marked nuclear pleomorphism and a higher mitotic count.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The most problematic condition included in the differential diagnosis is granular cell atypical fibroxanthoma (FXA), which affects individuals in the same age group as our patient, has similar immunohistochemical features, and occurs in the same location and on photodamaged skin.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> However, this condition can be ruled out based on the absence of a spindle-cell area, which is characteristic of FXA, as well as less marked cellular atypia and less mitotic activity without atypical mitoses.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Diagnosis is established by exclusion, mainly based on histology and immunohistochemistry findings. Treatment consists of complete excision.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Despite its atypical histological characteristics, this tumor exhibits benign behavior. However, the lack of studies of large series of patients makes it difficult to establish a long-term prognosis with certainty.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of Interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Medical History" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Physical Examination" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Histopathology" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Diagnosis" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Clinical Course and Treatment" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Comment" ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of Interest" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sagrera A, Montenegro T, Luján D. Tumor primitivo polipoide de células granulares. Actas Dermosifiliogr. 2021;112:839–840.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1254 "Ancho" => 1674 "Tamanyo" => 207367 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pink exophytic lesion on the outer canthus of the right eye.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1488 "Ancho" => 1674 "Tamanyo" => 315208 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Well-defined dermal tumor with a polypoid appearance (hematoxylin–eosin).</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 938 "Ancho" => 1674 "Tamanyo" => 394708 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Large cells with abundant eosinophilic cytoplasm containing granules, nuclear pleomorphism, and some mitotic forms (hematoxylin–eosin, original magnification ×40).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primitive polypoid granular-cell tumor and other cutaneous granular-cell neoplasms of apparent nonneural origin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.E. 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Calonje" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2559.2005.02192.x" "Revista" => array:6 [ "tituloSerie" => "Histopathology" "fecha" => "2005" "volumen" => "47" "paginaInicial" => "179" "paginaFinal" => "185" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16045779" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primitive nonneural granular cell tumor (so-called atypical polypoid granular cell tumor): report of 2 cases with immunohistochemical and ultrastructural correlation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.A. Habeeb" 1 => "S. Salama" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/DAD.0b013e318164101c" "Revista" => array:6 [ "tituloSerie" => "Am J Dermatopathol" "fecha" => "2008" "volumen" => "30" "paginaInicial" => "156" "paginaFinal" => "159" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18360120" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Granular cell atypical fibroxanthoma: report of two cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.J. Ríos" 1 => "M. Díaz" 2 => "D. Moreno" 3 => "A. García" 4 => "R. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 9 | 14 |
| 2024 October | 76 | 37 | 113 |
| 2024 September | 65 | 24 | 89 |
| 2024 August | 99 | 57 | 156 |
| 2024 July | 77 | 34 | 111 |
| 2024 June | 86 | 41 | 127 |
| 2024 May | 63 | 42 | 105 |
| 2024 April | 66 | 32 | 98 |
| 2024 March | 69 | 34 | 103 |
| 2024 February | 68 | 41 | 109 |
| 2024 January | 64 | 39 | 103 |
| 2023 December | 61 | 22 | 83 |
| 2023 November | 74 | 34 | 108 |
| 2023 October | 65 | 21 | 86 |
| 2023 September | 44 | 34 | 78 |
| 2023 August | 37 | 16 | 53 |
| 2023 July | 57 | 22 | 79 |
| 2023 June | 39 | 23 | 62 |
| 2023 May | 66 | 26 | 92 |
| 2023 April | 40 | 20 | 60 |
| 2023 March | 52 | 32 | 84 |
| 2023 February | 33 | 23 | 56 |
| 2023 January | 45 | 32 | 77 |
| 2022 December | 52 | 46 | 98 |
| 2022 November | 44 | 30 | 74 |
| 2022 October | 35 | 16 | 51 |
| 2022 September | 27 | 37 | 64 |
| 2022 August | 29 | 46 | 75 |
| 2022 July | 21 | 37 | 58 |
| 2022 June | 21 | 44 | 65 |
| 2022 May | 33 | 58 | 91 |
| 2022 April | 44 | 19 | 63 |
| 2022 March | 59 | 59 | 118 |
| 2022 February | 43 | 31 | 74 |
| 2022 January | 42 | 35 | 77 |
| 2021 December | 37 | 43 | 80 |
| 2021 November | 52 | 37 | 89 |
| 2021 October | 139 | 72 | 211 |
| 2021 September | 64 | 43 | 107 |
| 2021 August | 40 | 59 | 99 |
| 2021 July | 0 | 2 | 2 |
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