گرانولر سل تومور پوستی: گزارش موردی

زمینه و هدف: گرانولر سل تومور، یک تومور نادر بافت نرم با رشد کند و تدریجی است که به‌نظر می‌رسد منشاء آن از بافت عصبی باشد.معرفی بیمار: بیمار زن 27 ساله‌ای بود که به‌دلیل توده زیر جلدی که از شش ماه پیش در ناحیه اینگوینال چپ ایجاد شده بود در مهر 1396 به بیمارستان امام رضا بیرجند مراجعه کرده بود. توده مزبور دارای رشد تدریجی و فاقد درد بود. بیمار تحت عمل جراحی برداشت تومور قرار گرفت. توده در سطح به پوست چسبندگی کامل داشت لیکن در عمق و اطراف فاقد چسبندگی بود. بررسی پاتولوژیک اولیه و با رنگ‌آمیزی ایمونوهیستوشیمی نشان دهنده گرانولر سل تومور بود. در پیگیری، بیمار تا یک سال و نیم پس از عمل فاقد علایم عود یا متاستاز است.نتیجه‌گیری: در مواجهه با توده‌های نسج نرم که از نظر بالینی تشخیص واضحی وجود ندارد، این تومور نیز باید در تشخیص افتراقی، مورد توجه قرار گیرد.

Cutaneous granular cell tumor: case report

Background: Granular cell tumor (Abrikossoff rsquo;s tumor) is a rare and slowgrowing tumor of the soft tissue. Originated from the Schwann cells, it is often a benign tumor, but it can be malignant in 13% of the cases. Malignant cases can cause significant morbidity and mortality. It may develop in many anatomic locations, especially in the head and neck region, and also in skin and subcutaneous tissue.Case Presentation: The patient was a 27 years old female who was referred to the ImamReza Hospital of Birjand because of a subcutaneous mass in the left inguinal region. The tumor was appeared six months ago as a painless slowgrowing nodule. In physical examination, there was a 3 times;4 cm subcutaneous tumor in the left inguinal region. The tumor was attached to the skin but not to the deep and surrounding tissues. There was not any evidence of lymphadenopathy or distant metastasis. The patient was admitted in September 2017. The tumor was excised surgically with a one cm safe margin. The postoperative course was uneventful. In histopathology examination, there was a nonencapsulated neoplasm containing polygonal cells with round to oval nuclei and abundant fine paspositive granules in the eosinophilic cytoplasm. There were fibrous bands between the tumoral cells. Overlying epithelium shows foci of pseudoepitheliomatous hyperplasia. This finding was compatible with granular cell tumor. Immunohistochemistry (IHC) staining of the cytoplasm and the nucleus for s100 protein and cytoplasm for CD68 was also positive. The patient is symptomfree and without any sign of local recurrence or distant metastasis for 1.5 years postoperation.Conclusion: Although it rsquo;s a rare tumor, the granular cell tumor must be considered in the differential diagnosis of soft tissue tumors. Surgical excision with a safe margin is the treatment of choice for the tumor. It is recommended that the patients must be observed for two years postoperatively.