Granular cell tumors (GCTs) are uncommon soft tissue tumors of neural derivation, as supported by immunohistochemical and ultrastructural evidence. Vulvar involvement has been reported in 7–16%. This paper presents the cases of a 60-year-old woman and her 32-year-old niece with a strong family history of cancer, both presenting with an enlarging mass on their left labia majora. The lesions were treated by simple surgical excision. Histopathological examination revealed a benign vulvar GCT in both lesions. This is the first reported case of GCT of the vulva in the same family. The possible familial component of GCT needs further investigation. A systematic review of the literature on vulvar GCTs is carried out, the most complete one to date. This review unexpectedly reveals that there have been more than 130 cases of GCT of the vulva reported to date, only 7 of which were malignant. Since 5–25% of patients have multiple lesions, before planning treatment, clinicians should exclude multicentric lesions. After surgical treatment, if there is any evidence of tumor in the surgical margin, wider local excision should be performed. Regular follow-up is important for diagnosing a possible recurrence or a new lesion.

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This research proposes an innovative approach to evaluate modal shift from the road-only to the combined sea-road transport in order to implement new policies and introduce a Decision Support System (DSS) for the transportation planner’s decision. The impact of these is carried out by using an innovative simulation tool which has the capability to simulate the real choice process of all stakeholders involved, specifically modelling the freight forwarder’s point of view. The model runs as a single-agent based simulation which uses a multimodal network with detailed zoning. The simulation tool, capable of simulating the assignment of the whole network simultaneously, consists of a path choice model and a mode choice model for each o/d pair considered, establishing o/d pairs suitable and not suitable for modal shift. Three policies have been designed and tested through the simulation tool with an application in the Italian context: (1) internalization of the external costs of heavy vehicles; (2) introduction of a bonus for shipping companies; (3) design of new Ro-Ro services. The most affecting policy concerns an increase of speed of some Ro-Ro services to 22 kn, proposing a good balance between the navigation costs and the potential demand attracted.