Malignant granular cell tumor of the median nerve: a case report with a literature review of 157 cases

Skeletal Radiol. 2019 Feb;48(2):307-316. doi: 10.1007/s00256-018-3017-2. Epub 2018 Jul 6.

Abstract

Malignant granular cell tumors are an extremely rare, high-grade sarcoma with a schwannian phenotype and are composed of malignant granular cells with cytoplasmic lysosomal inclusion. To date, 157 cases of malignant granular cell tumors have been reported. We report the first case of a malignant granular cell tumor arising from the digital nerve to the median nerve in the palm, and we review the 157 previously reported cases and summarize the clinical profile, treatment, and outcome of this tumor. The median age, tumor size, and follow-up periods were 51 years, 6 cm, and 24 months respectively. With respect to the oncological result, 53 patients (33.8%) had no evidence for disease, 31 (19.7%) were alive with the disease, and 51 (32.5%) died because of the disease. Our case report indicates that rare malignant tumors can arise from the digital nerve to the median nerve in the palm, an anatomical site that is usually affected by benign lesions. Exhaustive discussions between surgeons and pathologists are necessary for the treatment of this rare malignant tumor.

Keywords: Granular cell tumor; Malignant granular cell tumor; Median nerve; Nerve sheath tumor.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Combined Modality Therapy
  • Contrast Media
  • Female
  • Granular Cell Tumor / diagnostic imaging*
  • Granular Cell Tumor / pathology
  • Granular Cell Tumor / therapy
  • Humans
  • Immunohistochemistry
  • Magnetic Resonance Imaging
  • Median Nerve / diagnostic imaging*
  • Median Nerve / pathology
  • Nerve Sheath Neoplasms / diagnostic imaging*
  • Nerve Sheath Neoplasms / pathology
  • Nerve Sheath Neoplasms / therapy
  • Positron-Emission Tomography
  • Tomography, X-Ray Computed

Substances

  • Contrast Media