Multimodal ultrasonography findings of extramammary granular cell tumors: Two case reports

Meng Zhu; Huan Xu; Yujuan Chen; Yulan Peng

doi:10.3389/fonc.2023.1136770

Multimodal ultrasonography findings of extramammary granular cell tumors: Two case reports

Front Oncol. 2023 Mar 20:13:1136770. doi: 10.3389/fonc.2023.1136770. eCollection 2023.

Authors

Meng Zhu¹, Huan Xu², Yujuan Chen³, Yulan Peng¹

Affiliations

¹ Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China.
² Department of Pathology, West China Hospital, Sichuan University, Chengdu, China.
³ Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China.

Abstract

Extramammary masses are infrequently encountered in breast examinations. They may occur in the chest wall and axilla as neighbors of the breast. It is important to determine the nature of the lesion. However, some benign tumors, such as granular cell tumors (GCTs), also show malignant characteristics, which leads to misdiagnosis. To the best of our knowledge, multimodal ultrasound features of GCT have not been elucidated. We report two cases of women with GCTs encountered upon breast cancer screening; the tumor was not located in breast tissue. The first patient was a 37-year-old woman who presented with a slow-growing mass in the right breast and the GCT was located in the pectoralis major muscle. The second patient was a 52-year-old woman who presented with a palpable left axillary mass and the GCT was located in the axilla. Mammography failed to detect the masses in the two patients upon breast cancer screening. However, two-dimensional ultrasonography revealed a solid heterogeneous hypoechoic mass. Shear wave elastography showed that the masses had an increased hardness compared with the surrounding tissue. Further contrast-enhanced ultrasonography showed that the contrast patterns of the two masses were different. In case one, contrast-enhanced ultrasonography showed an inhomogeneous annular high enhancement, and the dynamic curve showed rapid enhancement and regression. In case two, contrast enhanced ultrasound showed slight enhancement around the lesion but no enhancement inside. Postoperative pathology confirmed that the GCT was benign in both cases. The patients showed no signs of recurrence at the 2-year follow-up. Here, we report two cases and present the multimodal ultrasonography findings of this tumor for the first time. Radiologists and surgeons should be aware of these imaging manifestations and include them in their differential diagnoses.

Keywords: axillary; case reports; contrast-enhanced ultrasound; granular cell tumor; pectoralis major muscle; shear wave elasticity.

Publication types

Case Reports