Vulvar granular cell tumour in a recently post-partum woman: a case report

Abstract

Granular cell tumours (GCTs) are uncommon neuroectodermally derived tumours. Vulvar location is rare with 134 reported cases presenting as a non-specific vulvar mass. They are of low malignant potential and management is local excision. They have a high local recurrence rate if incompletely excised. The GCT diagnosis is often retrospective due to its rarity, its non-specific presenting symptoms and numerous differentials. Here we descibe the case of a 31-year-old woman presenting after an asymptomatic right labium majus mass was noted during a postnatal visit. This was imaged with magentic resonance imaging (MRI) and a biopsy was inconclusive. She was referred for subspecialty consultation at the Chris O’Brien Lifehouse. The lesion was five centimetres, overlying the pubis and inferolateral to the clitoris with no skin changes or epidermal attachment. Wide local excision was performed. Histopathology showed GCT features with no malignant characteristics, but positive margins. Despite positive margins, the decision was made to not complete re-excision and observe for recurrence. This was an unusual case in a young postpartum woman. It highlights the need for clinical suspicion of this tumour type during a postpartum examination and the need for nuanced decision making regarding re-excision based on individual patient needs despite recurrence risk.