Malignant granular cell tumor of the masseter muscle: Case report

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A 44-year-old woman initially presented with 3-cm diameter, firm mass in the right cheek (Fig 1) on November 27, 1995. There was no cervical lymphadenopathy detected. Results of the physical examination were unremarkable. Computed tomography showed an unclear outline of the mass, and the right masseter muscle appeared to be slightly enlarged. Magnetic resonance imaging clearly showed a tumor 3 cm in diameter in the right masseter muscle (Fig 2). The T1-weighted image generated a heterogeneous signal equal to that of the muscle. The T2-weighted image showed a tumor signal stronger than that of the muscle. The tumor was small, with a clear margin, and was first thought to be a fibroma or neurofibroma. However, a malignant tumor (eg, malignant fibrous histiocytoma) could not be ruled out because of the slight irregularity of the lesion. An ultrasound study of the right cheek showed a hypoechoic tumor without a clear capsule in the masseter muscle. Fine-needle aspiration obtained from the lesion consisted of small, round, cell nests without obvious nuclear atypia.

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