Slowly Enlarging Nodule on the Leg

REPORT OF A CASE A 56-year-old man presented with a 3-year history of a slowly enlarging, asymptomatic nodule on the anterior aspect of his left thigh. There was no history of trauma at the site and no other significant medical history. Physical examination revealed a fixed, 1.5-cm, dark brown, verrucous nodule on the anterior aspect of his left thigh (Fig 1). There were no palpable inguinal nodes. The differential diagnosis on initial evaluation included dermatofibroma, dermatofibrosarcoma protuberans, foreign body granuloma, nodular melanoma, verruca vulgaris, atypical fibroxanthoma, verrucous squamous cell carcinoma, tumor of appendageal origin, mycosis fungoides, and cutaneous metastasis. A complete excision to fascia was performed. Representative pathologic findings are shown in Figs 2 and 3. What is your diagnosis? DIAGNOSIS: Granular cell tumor. DISCUSSION Granular cell tumor was first described in 1926 by Abrikossoff, 1 and more than 1000 cases have been reported