Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2025;15(3):5433 1

Multicentric Granular Cell Tumor With Uncommon 
Dermoscopic Features

Inês Aparício Martins1, Alexandre João1, Juliana Baptista1, Cândida Fernandes1

1 Dermatology and Venereology Department, Unidade Local de Saúde de São José, Alameda Santo António dos Capuchos, Lisbon, Portugal

Citation: Aparício Martins I, João A, Baptista J, Fernandes C. Multicentric Granular Cell Tumor With Uncommon Dermoscopic Features. 
Dermatol Pract Concept. 2025;15(3):5433. DOI: https://doi.org/10.5826/dpc.1503a5433 

Accepted: April 23, 2025; Published: July 2025

Copyright: ©2025 Aparício Martins et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, 
distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing Interests: None.

Authorship: All authors have contributed significantly to this publication. 

Corresponding Author: Inês Aparício Martins, Alameda Santo António dos Capuchos, 1169-050 Lisbon, Portugal. Orcid ID: 0000-0002-
2572-2064. E-mail: inesapariciomartins@gmail.com

Case Presentation

A 38-year-old male presented with painless nodules on both 

arms, with two years of evolution. Physical examination 

revealed on posterior surface of the left arm a 3 cm hard 

erythematous adherent nodule, with an ulcerated center 

(Figure 1A). Additionally, on the right arm, a 4 cm hard sub-

cutaneous plaque, with a 1.5 cm erythematous-violaceous 

nodule in its lower portion was found (Figure B). Dermos-

copy of the left lesion showed central ulceration, serpentine 

and comma-shaped vessels, shiny white structures, and a 

yellow-brownish background (Figure 1C). Incisional biopsy 

revealed an infiltrative tumor, with abundant eosinophilic 

granules, pustulo-ovoid bodies of Milian and S100 and 

NSE staining, compatible with granular cell tumor (GCT). 

Excision of both lesions confirmed the diagnosis of multi-

centric GCT without atypia.

Teaching Point

GCT is a rare tumor originating in Schwann cells, typically 

presenting as an erythematous brownish or yellowish hard 

nodule with a smooth, verrucous, or ulcerated surface [1]. 

Although mostly benign, it is often infiltrative, and malig-

nancy occurs in 1%–3% of cases, [2]. The multicentric nature 

is described in 4%–30% of cases [1]. There are few dermo-

scopic reports of GCT in the literature. A yellowish color, 

peripherical brown reticular lines, and small white circles 

have been described [2]. However, central ulceration, serpen-

tine and comma-shaped vessels, and shiny white structures, 



2 Image Letter | Dermatol Pract Concept. 2025;15(3):5433

References

1. Marcoval J, Bauer-Alonso A, Llobera-Ris C, Moreno-Vilchez C, 

Penín RM, Bermejo J. Granular Cell Tumor: A Clinical Study 

of 81 Patients. Actas Dermosifiliogr. 2021 May;112(5):441-446. 

DOI: 10.1016/j.ad.2020.11.012. PMID: 33253647.

2. Corbella-Bagot L, Piquero-Casals J, Morgado-Carrasco D. 

 Dermoscopic Features of Granular Cell Tumor. Dermatol Pract 

Concept. 2023 Apr 1;13(2):e2023084. DOI: 10.5826/dpc 

.1302a84. PMID: 37196267.

Figure 1. (A, B)  Multicentric granular cell tumor (clinical image). (C) Dermoscopic image of the left lesion showing 

central ulceration, serpentine and comma-shaped vessels, shiny white structures, and a yellow-brownish background.

observed in our case, are uncommon findings. Surgical exci-

sion is recommended, but positive margins and recurrence 

can occur [1].

Clinical diagnosis of GCT is challenging due to its rar-

ity and the broad differential diagnosis, which includes both 

neoplastic and infectious diseases. Dermoscopy can be valu-

able, and new findings, as described here, may help improve 

diagnostic accuracy.