The clinical records of all patients with granular cell tumor seen at our institution over a 20-year period were reviewed. Three patients with malignant, and 37 with benign tumor, were identified. Eleven patients had multiple benign lesions. Three had a history of familial occurrence. Clinical and pathologic features and the management of this nebulous entity, in both its benign and malignant forms, are reviewed and discussed.

UTANEOUS SQUAMOUS CELL CARCINOMA is the SeC-C ond most common form of skin cancer.' Ninety percent of these patients are cured by surgery and/or radiation therapy, which appear to be equally effective. Metastasis is uncommon and is seen in only 5% to 10% of patients2; thus, systemic chemotherapy is rarely used in the treatment of this tumor. However, disease that occurs in antecedent scars, mucocutaneous junctions, immunosuppressed patients, and poorly differentiated tumors does metastasi~e,~ both to the regional lymph nodes and systemically, raising the need for systemic therapy.5-Fluorouracil (5-FU) is an effective topical chemotherapeutic agent for proliferative lesions in the skin, and the activity of 5-FU may relate to the higher thymidylate synthase activity seen in squamous cell carcinoma cell lines.4 Cis-daimminedichloroplatin (cisplatin) has been shown to have activity in squamous cell carcinoma, both in animal models5 and in Phase I1 studies.6 Because the combination of cisplatin and 5-FU is synergistic in a number of in vivo and in vitro tumor models,7 we hypothesized that this regimen would be effective in the treatment of squamous cell carcinoma of the skin.

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