Treatment of a large, ulcerating, granular-cell tumor by microscopically controlled excision

Malignant granular-cell tumors with benign histologic appearance are normally identified only following nodal and metastatic spread. Local recurrence following conventional excision of both the benign and malignant variant is not uncommon. A patient with a large, rapidly growing, spontaneously ulcerating granular-cell tumor was treated by microscopically controlled (Mohs) surgery. The rationale for this treatment, as well as criteria for the differentiation of the benign from the malignant variant, is discussed.