A rare cause of mons pubis growing mass of a vulvar granular cells tumor – a Case Report

A rare cause of mons pubis growing mass of a vulvar granular cells tumor – a Case Report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A rare cause of mons pubis growing mass of a vulvar granular cells tumor – a Case Report Sofia Jovina Domingues, Lúcia Correia, Vera Sousa, Ana Mendes, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2167218/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 22 Mar, 2023 Read the published version in SN Comprehensive Clinical Medicine → Version 1 posted 5 You are reading this latest preprint version Abstract Introduction: Granular cell tumor (GCT) is a rare clinical entity derived from Schwann cells of the outer sheath of the peripheral nerves, involving skin and subcutaneous tissue in most cases, but specifically GCT of the vulva is less frequent and labium majus is more prevalent site in vulva. The exact prevalence and pathogenesis of GCT haven’t been determined, but the risk of malignancy has been described at the rate of 2%. The authors report a case of 52-year-old postmenopausal woman, with a 2-year slow growth vulvar mass, without associated symptoms. On physical examination, a hard consistent and nodular subcutaneous mass, with 5 cm and located over the mons pubis was observed. Pelvic magnetic resonance identified a solid mass with irregular borders on subcutaneous tissue, upon mons pubis. An aspiration cytology was performed, suggesting a GCT leading a complete excision. Microscopically, GCT was compatible with a GCT without malignancy characteristics and the margins were negative. Conclusion: This case reports a GCT on the mons pubis, whose rare location have only been reported in three cases. Despites its benign behavior, the unusual size conditioned a more aggressive surgical treatment and a multidisciplinary approach. During follow-up vulva and other anatomical locations should be carefully observed, because of its unusual local or extragenital recurrence. Granular cell tumor vulvar Abrikossoff‘s tumor case report Figures Figure 1 Introduction Granular cell tumor (GCT) is a rare clinical entity derived from Schwann cells of the outer sheath of the peripheral nerves. It might appear at any anatomical location, involving skin and subcutaneous tissue in most cases (37%), but specifically GCT of the vulva is less frequent (3.4%) [ 1 ], being labium majus the most usual reported site of GCT of the vulva [ 2 ]. GCT has been reported since childhood to elderly with mean age of 45.8 years. The exact prevalence hasn’t been determined because its detailed morphological and clinical characteristics are unknown and most data are collected from small series or isolated cases. Pathogenesis of GCT is undetermined, but it seems to be secondary to chronic inflammation or trauma [ 1 ]. The risk of malignancy has been described at the rate of 2% [ 1 , 3 ]. This case highlights the diagnose and multidisciplinary approach for complete excision of GCT with an unusual size and anatomical location, on mons pubis. In the literature, only three cases of GCT on mons pubis has been reported. Patient consent for this report was obtained. Presentation The authors report a case of 52-year-old postmenopausal woman, with no medical history, who referred to Gynecology Oncology consultation due a 2-year slow growth vulvar mass, without associated symptoms. The patient recognized discomfort with the mass, but denied erythema, swelling, or rapid enlargement. Also, no history of trauma was informed. On physical examination, a hard consistent and nodular subcutaneous mass, measuring approximately 5 cm and located over the mons pubis, less than 1 cm distant to clitoris, was observed. There was no sign of discharge or bleeding. No enlarged inguinal lymph nodes were identified. Soft tissue ultrasound revealed a solid mass with no vascularization and a pelvic magnetic resonance identified a solid mass with irregular borders on subcutaneous tissue, upon mons pubis with 42 x 40 x 30 mm, without deep plans infiltration. Also, no enlarged inguinal or pelvic lymph nodes were recognized (Fig. 1 A). An aspiration cytology was performed and its examination showed an epithelioid neoplasm with granular cytoplasm with S100 and CD68 diffuse expression, suggesting a granular cell tumor. After four months, an eventful complete excision of the lesion, under general anaesthesia was done (Fig. 1 B). Intraoperative surgical margins evaluation allowed deep clitoral-sparing. Vulvar wound was reduced and covered with a bi-layer matrix for dermal regeneration (Fig. 1 E) allowing reconstructing surgery three weeks later, by a mini-abdominoplasty (Fig. 1 F-G). Macroscopically, the mass measured 65 x 55 x 40 mm and the cut surface was white homogenous, hard and the margins were negative (Fig. 1 C). Microscopy revealed features of epithelioid polygonal cells with round to oval non-atypical nuclei and abundant eosinophilic granular cytoplasm. (Fig. 1 D). On the follow-up appointment six weeks and four months after the excision procedure, the patient was asymptomatic and presented a complete healed scar with no induration. Discussion/conclusion This case reports a GCT on the mons pubis, whose rare location have only been reported in three cases [ 4 ]. Cytological analysis of the tumor was crucial to accurate diagnosis and surgical planning in order to complete excision of the tumor, that remains the primary treatment modality for GCT [ 4 ]. Microscopically, GCT was compatible with a GCT without malignancy characteristics, based on grading system that was introduced for GCT to triage patients that classified tumors into benign, atypical, and malignant subtypes based on histologic features [ 5 ]. Despites its benign behavior, the unusual size conditioned a more aggressive surgical treatment and a multidisciplinary approach, including combined gynecologic and plastic surgery. Firstly, excision tumor was performed by gynecological surgeons, and then vulvar wound was reduced and covered with a bi-layer matrix providing a dermal regeneration by plastic surgeons. A reconstructing surgery, including by a mini-abdominoplasty, was performed three weeks later. Local surgical excision is generally curative for benign tumors and tumor recurrence has been described in local excisions with positive margins, reporting almost 20% cases showed positive margins and of those 20% developed local recurrence or GCT with malignant features. [ 1 ] Even thought, during follow-up vulva and other anatomical locations, such as oral cavity and trunk, should be carefully observed, because of its uncommon extragenital recurrence [ 4 ]. Present case report relies on early accurate diagnose before surgery, with a detailed description of tumor excision and reconstruction by a multidisciplinary team, contributing to our knowledge on this subject. Also, the surgical treatment challenge with a multidisciplinary approach was essential to reduce and disguise the lesion, reducing the impact on the patient’s quality of life. However, it is important to be aware of the possibility of malignancy and different clinical implications. This case highlights the diagnose and multidisciplinary approach for complete excision of GCT with an unusual size and anatomical location, on mons pubis. Declarations - Funding: The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. - Competing Interests: The authors have no conflicts of interest. - Consent to participate: The patient provided verbal and written consent for the inclusion of their personal information in the presented manuscript for publication. - Ethics approval: The manuscript was not considered to require ethics approval by the institutional ethics review committee. - Consent to publish: The patient provided verbal and written consent for publication. - Availability of data and material (data transparency): Not applicable to this article. - Code availability: Not applicable to this article. - Author contributions: SJD was responsible for the paper’s conception, literature review and manuscript drafting. LC performed the surgery and contributed for revision and approval of the manuscript. VS was responsible for the initial clinical patient’ evaluation, review and approval of the manuscript. AM performed the surgery, review and approval of the manuscript. FR provided the anatomical pathology images and contributed to review and approval of the manuscript. AFJ reviewed and approved the final version of the manuscript. References Mobarki M, Dumollard JM, Dal Col P, Camy F, Peoc'h M, Karpathiou G. Granular cell tumor a study of 42 cases and systemic review of the literature. Pathol Res Pract. 2020 Apr;216(4):152865. Althausen AM, Kowalski DP, Ludwig ME, Curry SL, Greene JF. Granular cell tumors: a new clinically important histologic finding. Gynecol Oncol. 2000;77(2):310–3. “,”, . Kavak ZN, Gökaslan H, Küllü S. Vulvar granular cell tumor (ABRIKOSSOFF TUMOR); a tumor of vulva which is rare but needs care. Gynecol Oncol Rep. 2021;36:100767. Patabendige M, Wickramasooriya DJ, Dasanayake L. Granular Cell Tumor over the Mons Pubis: An Uncommon Tumor. Case Rep Obstet Gynecol. 2019;2019:1279137. Fanburg-Smith JC, Meis-Kindblom JM, Fante R, Kindblom LG. Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol. 1998;22(7):779–94.A. Cite Share Download PDF Status: Published Journal Publication published 22 Mar, 2023 Read the published version in SN Comprehensive Clinical Medicine → Version 1 posted Reviewers agreed at journal 21 Dec, 2022 Reviewers invited by journal 19 Dec, 2022 Editor assigned by journal 19 Dec, 2022 First submitted to journal 18 Dec, 2022 Editorial decision: Minor revisions 16 Nov, 2022 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2167218","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":161168499,"identity":"0a23b707-ac5e-4ff9-9843-76ac85da56cc","order_by":0,"name":"Sofia Jovina Domingues","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABB0lEQVRIiWNgGAWjYFACxgcHGHiYwcwDDAw2IJHGA/i1MBtAtTCDtKSBtDQQ1AJWDsEMh2HW4Qby7c2MB37IWEfzzz5/8HDBn/N2a9sPA22psYnGpcXgzGGGgz086bkzziUzHJ7Zdjt525lEoJZjabkNuLRI5B84wMNzOLfhDDPDYd6G28lmB4BaGBsO49QiPyOZ4eAfoJb5IC08f84lm51/iF8Lww2ge0C2bABrYTtgZ3aDgC0gvxyWAfpl4xlmg8O8bckJZjeAtiTg8QswxJg/vu2xzp13hvHxZ54/dvZm59MfPvhQY4PbYSDA2INgJ4JVJuBTDgY/EEx7gopHwSgYBaNgxAEAesxopvQwbo8AAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0003-3712-2952","institution":"Centro Hospitalar de Setubal EPE","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Sofia","middleName":"Jovina","lastName":"Domingues","suffix":""},{"id":161168500,"identity":"ea9d2a1a-cc3c-4e68-ac16-c7a9261d8771","order_by":1,"name":"Lúcia Correia","email":"","orcid":"","institution":"Instituto Português de Oncologia de Lisboa Francisco Gentil EPE: Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Lúcia","middleName":"","lastName":"Correia","suffix":""},{"id":161168501,"identity":"2c982e0d-a754-40d0-b037-711deaac6b6d","order_by":2,"name":"Vera Sousa","email":"","orcid":"","institution":"Instituto Português de Oncologia de Lisboa: Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Vera","middleName":"","lastName":"Sousa","suffix":""},{"id":161168502,"identity":"8b6dddf4-0794-40e8-b471-eed1fbf029d1","order_by":3,"name":"Ana Mendes","email":"","orcid":"","institution":"Instituto Português de Oncologia de Lisboa: Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ana","middleName":"","lastName":"Mendes","suffix":""},{"id":161168503,"identity":"be62f1c4-034b-48b8-95a5-a10c1d58467c","order_by":4,"name":"Filipa Rosa","email":"","orcid":"","institution":"Instituto Português de Oncologia de Lisboa Francisco Gentil EPE: Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Filipa","middleName":"","lastName":"Rosa","suffix":""},{"id":161168504,"identity":"6e92c7d3-4d46-4e24-ba20-ba2abcf4c696","order_by":5,"name":"Ana Francisca Jorge","email":"","orcid":"","institution":"Instituto Português de Oncologia de Lisboa: Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ana","middleName":"Francisca","lastName":"Jorge","suffix":""}],"badges":[],"createdAt":"2022-10-14 17:17:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2167218/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2167218/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s42399-023-01445-9","type":"published","date":"2023-03-22T20:06:09+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":30629885,"identity":"54c61fbd-10d3-41c4-862d-7e016caf0ee8","added_by":"auto","created_at":"2022-12-21 15:11:16","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1094445,"visible":true,"origin":"","legend":"\u003cp\u003e1. Magnetic resonance imaging axial images: T1 and T2 weighted showing a hypointense well-delimited, exophytic, solid mass;\u003c/p\u003e\n\u003cp\u003e2. Immediately after tumor excision;\u003c/p\u003e\n\u003cp\u003e3. Macroscopic appearance and cross section of the surgical specimen shows a subcutaneous white homogenous tumor with well-defined borders. Intraoperative assessment confirmed negative surgical margins (black ink);\u003c/p\u003e\n\u003cp\u003e4. Scan magnification shows a subcutaneous eosinophilic tumor with infiltrative borders. It is composed of epithelioid polygonal cells with round to oval non-atypical nuclei and abundant eosinophilic granular cytoplasm, as observed at higher magnification (haematoxylin and eosin);\u003c/p\u003e\n\u003cp\u003e5. Bi-layer matrix for dermal regeneration is covering the vulvar wound;\u003c/p\u003e\n\u003cp\u003e6. Three weeks after tumor excision;\u003c/p\u003e\n\u003cp\u003e7. After mini-abdominoplasty.\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-2167218/v1/da539f7eea80b136186a94cd.jpeg"},{"id":44723151,"identity":"7cc17f05-f14b-4ec3-8590-944f5e80056a","added_by":"auto","created_at":"2023-10-16 20:14:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":356984,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2167218/v1/226ade1b-c464-41e0-a9cb-8eb4de36e40e.pdf"}],"financialInterests":"","formattedTitle":"A rare cause of mons pubis growing mass of a vulvar granular cells tumor – a Case Report","fulltext":[{"header":"Introduction","content":"\u003cp\u003eGranular cell tumor (GCT) is a rare clinical entity derived from Schwann cells of the outer sheath of the peripheral nerves. It might appear at any anatomical location, involving skin and subcutaneous tissue in most cases (37%), but specifically GCT of the vulva is less frequent (3.4%) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], being labium majus the most usual reported site of GCT of the vulva [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. GCT has been reported since childhood to elderly with mean age of 45.8 years. The exact prevalence hasn\u0026rsquo;t been determined because its detailed morphological and clinical characteristics are unknown and most data are collected from small series or isolated cases. Pathogenesis of GCT is undetermined, but it seems to be secondary to chronic inflammation or trauma [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The risk of malignancy has been described at the rate of 2% [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis case highlights the diagnose and multidisciplinary approach for complete excision of GCT with an unusual size and anatomical location, on mons pubis. In the literature, only three cases of GCT on mons pubis has been reported. Patient consent for this report was obtained.\u003c/p\u003e"},{"header":"Presentation","content":"\u003cp\u003eThe authors report a case of 52-year-old postmenopausal woman, with no medical history, who referred to Gynecology Oncology consultation due a 2-year slow growth vulvar mass, without associated symptoms. The patient recognized discomfort with the mass, but denied erythema, swelling, or rapid enlargement. Also, no history of trauma was informed. On physical examination, a hard consistent and nodular subcutaneous mass, measuring approximately 5 cm and located over the mons pubis, less than 1 cm distant to clitoris, was observed. There was no sign of discharge or bleeding. No enlarged inguinal lymph nodes were identified.\u003c/p\u003e \u003cp\u003eSoft tissue ultrasound revealed a solid mass with no vascularization and a pelvic magnetic resonance identified a solid mass with irregular borders on subcutaneous tissue, upon mons pubis with 42 x 40 x 30 mm, without deep plans infiltration. Also, no enlarged inguinal or pelvic lymph nodes were recognized (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA). An aspiration cytology was performed and its examination showed an epithelioid neoplasm with granular cytoplasm with S100 and CD68 diffuse expression, suggesting a granular cell tumor. After four months, an eventful complete excision of the lesion, under general anaesthesia was done (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eB). Intraoperative surgical margins evaluation allowed deep clitoral-sparing. Vulvar wound was reduced and covered with a bi-layer matrix for dermal regeneration (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eE) allowing reconstructing surgery three weeks later, by a mini-abdominoplasty (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eF-G). Macroscopically, the mass measured 65 x 55 x 40 mm and the cut surface was white homogenous, hard and the margins were negative (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eC). Microscopy revealed features of epithelioid polygonal cells with round to oval non-atypical nuclei and abundant eosinophilic granular cytoplasm. (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eD). On the follow-up appointment six weeks and four months after the excision procedure, the patient was asymptomatic and presented a complete healed scar with no induration.\u003c/p\u003e"},{"header":"Discussion/conclusion","content":"\u003cp\u003eThis case reports a GCT on the mons pubis, whose rare location have only been reported in three cases [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCytological analysis of the tumor was crucial to accurate diagnosis and surgical planning in order to complete excision of the tumor, that remains the primary treatment modality for GCT [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Microscopically, GCT was compatible with a GCT without malignancy characteristics, based on grading system that was introduced for GCT to triage patients that classified tumors into benign, atypical, and malignant subtypes based on histologic features [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Despites its benign behavior, the unusual size conditioned a more aggressive surgical treatment and a multidisciplinary approach, including combined gynecologic and plastic surgery. Firstly, excision tumor was performed by gynecological surgeons, and then vulvar wound was reduced and covered with a bi-layer matrix providing a dermal regeneration by plastic surgeons. A reconstructing surgery, including by a mini-abdominoplasty, was performed three weeks later. Local surgical excision is generally curative for benign tumors and tumor recurrence has been described in local excisions with positive margins, reporting almost 20% cases showed positive margins and of those 20% developed local recurrence or GCT with malignant features. [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] Even thought, during follow-up vulva and other anatomical locations, such as oral cavity and trunk, should be carefully observed, because of its uncommon extragenital recurrence [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePresent case report relies on early accurate diagnose before surgery, with a detailed description of tumor excision and reconstruction by a multidisciplinary team, contributing to our knowledge on this subject. Also, the surgical treatment challenge with a multidisciplinary approach was essential to reduce and disguise the lesion, reducing the impact on the patient\u0026rsquo;s quality of life. However, it is important to be aware of the possibility of malignancy and different clinical implications.\u003c/p\u003e \u003cp\u003eThis case highlights the diagnose and multidisciplinary approach for complete excision of GCT with an unusual size and anatomical location, on mons pubis.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e- \u003cstrong\u003eFunding:\u003c/strong\u003e The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Competing Interests:\u003c/strong\u003e The authors have no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Consent to participate: \u003c/strong\u003eThe patient provided verbal and written consent for the inclusion of their personal information in the presented manuscript for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Ethics approval:\u003c/strong\u003e The manuscript was not considered to require ethics approval by the institutional ethics review committee.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Consent to publish: \u003c/strong\u003eThe patient provided verbal and written consent for publication.\u003c/p\u003e\n\u003cp\u003e- \u003cstrong\u003eAvailability of data and material (data transparency): \u003c/strong\u003eNot applicable to this article.\u003c/p\u003e\n\u003cp\u003e- \u003cstrong\u003eCode availability:\u003c/strong\u003e Not applicable to this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Author contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSJD was responsible for the paper\u0026rsquo;s conception, literature review and manuscript drafting.\u003c/p\u003e\n\u003cp\u003eLC performed the surgery and contributed for revision and approval of the manuscript.\u003c/p\u003e\n\u003cp\u003eVS was responsible for the initial clinical patient\u0026rsquo; evaluation, review and approval of the manuscript.\u003c/p\u003e\n\u003cp\u003eAM performed the surgery, review and approval of the manuscript.\u003c/p\u003e\n\u003cp\u003eFR provided the anatomical pathology images and contributed to review and approval of the manuscript.\u003c/p\u003e\n\u003cp\u003eAFJ reviewed and approved the final version of the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eMobarki M, Dumollard JM, Dal Col P, Camy F, Peoc'h M, Karpathiou G. Granular cell tumor a study of 42 cases and systemic review of the literature. Pathol Res Pract. 2020 Apr;216(4):152865.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlthausen AM, Kowalski DP, Ludwig ME, Curry SL, Greene JF. Granular cell tumors: a new clinically important histologic finding. Gynecol Oncol. 2000;77(2):310\u0026ndash;3. \u0026ldquo;,\u0026rdquo;, .\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKavak ZN, G\u0026ouml;kaslan H, K\u0026uuml;ll\u0026uuml; S. Vulvar granular cell tumor (ABRIKOSSOFF TUMOR); a tumor of vulva which is rare but needs care. Gynecol Oncol Rep. 2021;36:100767.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePatabendige M, Wickramasooriya DJ, Dasanayake L. Granular Cell Tumor over the Mons Pubis: An Uncommon Tumor. Case Rep Obstet Gynecol. 2019;2019:1279137.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFanburg-Smith JC, Meis-Kindblom JM, Fante R, Kindblom LG. Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol. 1998;22(7):779\u0026ndash;94.A.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"sn-comprehensive-clinical-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sncm","sideBox":"Learn more about [SN Comprehensive Clinical Medicine](https://www.springer.com/journal/42399)","snPcode":"42399","submissionUrl":"https://submission.nature.com/new-submission/42399/3","title":"SN Comprehensive Clinical Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Granular cell tumor, vulvar, Abrikossoff‘s tumor , case report","lastPublishedDoi":"10.21203/rs.3.rs-2167218/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2167218/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eIntroduction: Granular cell tumor (GCT) is a rare clinical entity derived from Schwann cells of the outer sheath of the peripheral nerves, involving skin and subcutaneous tissue in most cases, but specifically GCT of the vulva is less frequent and labium majus is more prevalent site in vulva. The exact prevalence and pathogenesis of GCT haven’t been determined, but the risk of malignancy has been described at the rate of 2%. The authors report a case of 52-year-old postmenopausal woman, with a 2-year slow growth vulvar mass, without associated symptoms. On physical examination, a hard consistent and nodular subcutaneous mass, with 5 cm and located over the mons pubis was observed. Pelvic magnetic resonance identified a solid mass with irregular borders on subcutaneous tissue, upon mons pubis. An aspiration cytology was performed, suggesting a GCT leading a complete excision. Microscopically, GCT was compatible with a GCT without malignancy characteristics and the margins were negative.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusion: This case reports a GCT on the mons pubis, whose rare location have only been reported in three cases. Despites its benign behavior, the unusual size conditioned a more aggressive surgical treatment and a multidisciplinary approach. During follow-up vulva and other anatomical locations should be carefully observed, because of its unusual local or extragenital recurrence.\u003c/p\u003e","manuscriptTitle":"A rare cause of mons pubis growing mass of a vulvar granular cells tumor – a Case Report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-12-21 15:11:11","doi":"10.21203/rs.3.rs-2167218/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"","date":"2022-12-21T10:14:32+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2022-12-19T08:47:26+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2022-12-19T08:20:40+00:00","index":"","fulltext":""},{"type":"submitted","content":"SN Comprehensive Clinical Medicine","date":"2022-12-18T13:16:57+00:00","index":"","fulltext":""},{"type":"decision","content":"Minor revisions","date":"2022-11-17T04:15:11+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"sn-comprehensive-clinical-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sncm","sideBox":"Learn more about [SN Comprehensive Clinical Medicine](https://www.springer.com/journal/42399)","snPcode":"42399","submissionUrl":"https://submission.nature.com/new-submission/42399/3","title":"SN Comprehensive Clinical Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"0d58fe49-ed48-4a04-ba14-84d665f94d10","owner":[],"postedDate":"December 21st, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2023-10-16T20:10:13+00:00","versionOfRecord":{"articleIdentity":"rs-2167218","link":"https://doi.org/10.1007/s42399-023-01445-9","journal":{"identity":"sn-comprehensive-clinical-medicine","isVorOnly":false,"title":"SN Comprehensive Clinical Medicine"},"publishedOn":"2023-03-22 20:06:09","publishedOnDateReadable":"March 22nd, 2023"},"versionCreatedAt":"2022-12-21 15:11:11","video":"","vorDoi":"10.1007/s42399-023-01445-9","vorDoiUrl":"https://doi.org/10.1007/s42399-023-01445-9","workflowStages":[]},"version":"v1","identity":"rs-2167218","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2167218","identity":"rs-2167218","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}