Grannular Cell Tumor

The authors reported two cases of intracranial granular cell tumor which had no apparent continuity to the pituitary area. The first case was 7 year-old female who was in good health and in normal development until Oct. 1972, when the patient gradually developed signs of increased intracranial pressure and right hemiparesis. The patient was admitted to the Department of Neurosurgery, Nagasaki University School of Medicine on Feb. 22, 1973. The patient was found to be lethargic and had severe choked discs. A brain scan indicated increased uptake in the left frontal area and a CAG was abnormal with a large mass lesion in the area, displacing the midline structure as much as 2 cm to the right side. The mass lesion was relatively avascular although the left frontopolar artery was dilated and seemed to be perfusing the tumor. On February 25th, subtotal removal of the tumor was performed. The tumor attached to the dura in its superior aspect but the medial portion of the tumor was separated from the falx by thin sheet of the brain tissue through which the dilated frontopolar artery distributed in the tumor. The rest of the tumor was totally removed 10 days later when the operative area vulged out and wound dehescience was imminent. The inferior border of the tumor was well in the brain tissue and there were no indication to suggest the tumor tissue continuity to the pituitary area. Histologically, the tumor tissue resembled to so called granular cell myoblastoma, having the characteristic intracytoplasmic granules. The granules were negative to PAS and Orange G stain. The tumor cells gathered in nests of various size which were surrounded by the connective tissue. The nests were further subdivided into smaller groups by reticulin fibers. The nucleus differed in size and shape. Mitosis were found numerously, indicating malignant nature of this tumor. On electronmicroscopic examination, the tumor cells were easily identified by presence of the aboundant intracytoplasmic granules which were classified tentatively by the authors in 5 types as (1) vacuoles containing fine granules of low density, (2) uniform dense body, (3) dense body with smaller dense granules of lower density, (4) dense body with vacuoles and (5) compound dense body with granules of (1) to (4). Glycogen particles were found in between these granules. No basement membrane covered the cell. No specific junction structures were noted. The cells cultured from the tissue taken during the 3rd operation