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Foti C. 1, Cassano N. 1, Vestita M. 1, Zito F. A. 2, Popescu O. 3, Ferrorelli E. 4, Vena G. A. 1
1 Department of Biomedical Sciences and Human Oncology, Dermatology Clinic, University of Bari, Italy
2 Unit of Pathology, Ospedale Di Venere, Bari, Catania, Italy
3 Department of Pathology, National Cancer Institute, Bari, Italy
4 Institute of General Surgery and Laparoscopic Approach “G. Marinaccio”, University of Bari, Italy
Granular cell tumor (GCT) is an uncommon tumor of neural origin which can appear in virtually any site of the body, and occasionally in the breast. We describe the case of a young woman with a painful slow-growing plaque arranged along the left nipple circumference showing inflammatory signs. Treatment with systemic and topical antibiotics, in combination with a corticosteroid ointment, induced only a modest improvement of the inflammatory changes. Histopathologic examination of a punch biopsy specimen taken from the plaque revealed the presence of nests of large polyhedral cells with a granular cytoplasm. Immunohistochemical staining evidenced the positivity of these cells for S-100 protein, neuron-specific enolase and CD68, along with the negativity for pan-cytokeratin and HMB-45. Based on these findings, the diagnosis of GCT was made and the plaque was surgically excised with no recurrence during a 6-month follow-up period. GCT of the nipple should be differentiated from several malignant and benign conditions, including breast cancer, Paget’s disease, leiomyoma, and chronic eczema. Diagnosis of GCT can be made only performing histopathological and immunohistochemical studies, which are also useful to discriminate the possible albeit rare variants of malignant GCT. Biopsy is a fundamental step before taking definite decisions on the therapeutical management in order to avoid inappropriate surgical procedures.