Intramuscular tumor detected by FDG positron emission tomography scanning following postoperative lung cancer.
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We have presented a series of 19 new cases of granular cell tumors of the tongue. This benign condition is often difficult to diagnose if an adequate biopsy specimen has not been obtained. Insufficient biopsy material that includes only the overlying pseudoepitheliomatous hyperplasia may distort the pathologic picture. Review of frozen sections should provide an accurate diagnosis, and local surgical excision should resolve the problem completely.
A granular cell myoblastoma of the parapharyngeal space is presented. Although uncommon, this neoplasm of controversial origin must be considered in the differential diagnosis of all nonenhancing parapharyngeal space masses.
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The clinical and pathological characteristics of a myoblastoma of the orbital are described. The tumor presented as a painless hard mass in the left orbit of a 56-year-old caucasian male, causing diplopia and hypertrophy of the left eye in the primary visual position. Light microscopy studies revealed a typical granular cell tumor with PAS-positive intracytoplasmic granules. Immunoperoxidase studies showed positivity for S-100 protein and desmin. Electron microscopy studies showed numerous intracellular myelin degenerative bodies. The patient developed an epidermoid cyst at the site of initial surgery, but has no signs of local or distant disease two years after initial treatment.
A granular cell tumor in the spinal canal that presented with subarachnoid hemorrhage is reported. The tumor was totally excised. The pathogenic and clinical aspects are discussed.
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Granular cell myoblastoma is an uncommon benign tumor. The diagnosis is rarely suspected preoperatively, and the clinician is frequently baffled or frightened by an unfamiliar diagnosis. Twenty-eight patients with the diagnosis of granular cell myoblastoma presented for treatment at Richmond Eye and Ear Hospital and the Medical College of Virginia Hospitals between January 1, 1952, and December 31, 1974. The authors believe that this is one of the largest series of cases reported in the world literature. The tumor presents most often in the fourth decade of life and about equally in the sexes. Of interest is the nearly 5:1 predominance in the Negro race compared to the Caucasian race.
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A patient had multicentric endobronchial granular cell myoblastoma. Progression with worsening tracheal obstruction following carbon dioxide laser therapy led to surgical resection. Flow volume loops documented progressive relief of airway obstruction after laser and resectional surgery. Our experience with failure of laser therapy supports previous recommendations for surgical therapy for large (greater than 8 mm) lesions of the trachea.
Granular cell myoblastomas of the trachea and right upper lobe bronchus were discovered incidentally during therapeutic bronchoscopy. Because of their propensity to cause airway compromise and distal atelectasis, ablation of both lesions was undertaken. This is the first reported case of bipolar cautery of GCM through a flexible fiberoptic bronchoscope. Small tumor size and lack of atelectasis permitted utilization of this technique. Long-term follow-up is necessary to compare this therapy with other nonresectional therapies.
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The patient who presents with jaundice, regardless of the etiology, cannot be adequately examined by a gallbladder series and intravenous cholangiography. Clinical evaluation aided by laboratory analysis will not always differentiate between primary liver parenchymal disease and biliary tract obstruction. Percutaneous transhepatic cholangiography, when successfully performed, answers the question of whether the jaundice is due to primary liver parenchymal disease or due to biliary tract obstruction. The point to emphasize is that under no circumstances is it appropriate to presume any information if the biliary system is not entered and visualized successfully. The proper interpretation of the level of block can fall prey to the mistake of incomplete aspiration of the thick, inspissated bile in the obstructed biliary tree before injection of contrast material. The problem will be worsened by a peripheral entrance into the biliary system rather than a more central one. Gastrointestinal series should always be available to aid in identifying pathology at the entrace of the common bile duct into the duodenum. Lastly, identifying the etiology at the site of the block will require additional procedures. Selective visceral angiography has contributed greatly in this area. During the 20 years of clinical usage of percutaneous transhepatic cholangiography, we feel it has become the single examination capable of preventing unnecessary exploration of the jaundiced patient with primary liver parenchymal disease and the most useful potential source of practical information if laparotomy is necessary to correct biliary tract obstruction.
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