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Jian R, Shi Y, Li T, Zhou N, Wang X, Li S. Diagnosis and management of oesophageal granular cell tumour: A case report. Exp Ther Med 2025; 29:92. [PMID: 40162053 PMCID: PMC11947864 DOI: 10.3892/etm.2025.12842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2024] [Accepted: 02/17/2025] [Indexed: 04/02/2025] Open
Abstract
Granular cell tumours (GCTs) are rare and typically benign neoplasms that can arise in various parts of the body, including the oesophagus. These tumours are considered to originate from Schwann cells and are characterized by their granular cytoplasm. Oesophageal GCTs (EGCTs) are particularly uncommon and often present with non-specific symptoms, making their diagnosis challenging. The present case report documents the case of a 68-year-old male patient who was admitted to the Affiliated Hospital of Jiujiang University (Jiujiang, China) after the incidental discovery of a submucosal oesophageal mass during a routine health examination. Upon diagnostic evaluation, including endoscopy and histopathological analysis, an EGCT was identified. Endoscopic ultrasonography revealed submucosal protrusion of the lower oesophagus, where endoscopic submucosal dissection (ESD) was subsequently performed. Histopathological staining and immunohistochemistry (IHC) indicated the presence of a GCT with positivity for S-100. The patient successfully underwent ESD without any complications. Although EGCTs are typically benign, they have the potential for malignant transformation and therefore require careful evaluation. The present case highlights the importance of differentiating EGCTs from other submucosal oesophageal lesions through histological and IHC methods. In particular, early detection and appropriate management are crucial for optimal patient outcomes. In conclusion, EGCT is a rare entity with a generally favourable prognosis when detected early. The present case underscores the importance of considering EGCTs in the differential diagnosis of oesophageal submucosal lesions and outlines the role of endoscopic and histopathological evaluation in their management.
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Affiliation(s)
- Rui Jian
- Jiangxi Provincial Key Laboratory of Cell Precision Therapy, School of Basic Medical Sciences, Jiujiang University, Jiujiang, Jiangxi 332005, P.R. China
| | - Yanqing Shi
- Department of Gastroenterology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi 332005, P.R. China
| | - Ting Li
- Department of Pathology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi 332005, P.R. China
| | - Nanhao Zhou
- Jiangxi Provincial Key Laboratory of Cell Precision Therapy, School of Basic Medical Sciences, Jiujiang University, Jiujiang, Jiangxi 332005, P.R. China
| | - Xijin Wang
- Department of Gastroenterology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi 332005, P.R. China
| | - Shan Li
- Jiangxi Provincial Key Laboratory of Cell Precision Therapy, School of Basic Medical Sciences, Jiujiang University, Jiujiang, Jiangxi 332005, P.R. China
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2
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Li H, Zhang M, Zheng Y, Zhang H. Gastric granular cell tumor: A case report and literature review. Oncol Lett 2024; 28:403. [PMID: 38983126 PMCID: PMC11228929 DOI: 10.3892/ol.2024.14536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 06/11/2024] [Indexed: 07/11/2024] Open
Abstract
Granular cell tumors (GCTs) are neoplasms of uncertain histopathological etiology and therefore there are no universally accepted treatment strategies. GCTs are characterized by abundant eosinophilic granules. Since they are predominantly located in the skin and subcutaneous tissues, gastric GCTs are exceedingly rare. The present study documents the case of a 52-year-old man who visited the Gastroenterology Clinic of the People's Hospital of Putuo District (Zhoushan, China) due to upper abdominal fullness. Endoscopic ultrasonography revealed a well-defined hypoechoic nodule in the submucosal layer of the stomach body. The lesion was completely excised using endoscopic submucosal dissection and the patient made a full postoperative recovery. Immunohistochemistry showed positivity for S100 and CD68, with CD34 expression surrounding the tumor cells. At telephone follow-up until May 2024, the patient's fullness and discomfort were noted to be relieved. The characteristics of the CD34 expression pattern may serve as a novel basis for the pathological diagnosis of gastric GCTs. Endoscopic resection is a feasible option for gastric GCTs smaller than 2 cm.
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Affiliation(s)
- Huixi Li
- Department of Pathology, People's Hospital of Putuo District, Zhoushan, Zhejiang 316000, P.R. China
| | - Miao Zhang
- Department of Pathology, People's Hospital of Putuo District, Zhoushan, Zhejiang 316000, P.R. China
| | - Youyou Zheng
- Department of Gastroenterology, People's Hospital of Putuo District, Zhoushan, Zhejiang 316000, P.R. China
| | - Hong Zhang
- Department of Obstetrics and Gynecology, People's Hospital of Putuo District, Zhoushan, Zhejiang 316000, P.R. China
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3
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Miró M, Rivas F, López A, Farran L. Cervical esophaguectomy plus tracheal resection and free jeyuno graft as treatment of esophageal granular cell tumor. Cir Esp 2020; 99:147-151. [PMID: 33268150 DOI: 10.1016/j.ciresp.2020.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/01/2020] [Accepted: 09/06/2020] [Indexed: 11/17/2022]
Abstract
Granular cell tumor is a very rare entity (0.03%) with controversial management, due to its low incidence and its usually benign behavior (98%). Its location in the digestive tract is unusual (3-11%), being the esophagus the most frequently affected organ, with about 400 published cases. However, the incidence in the cervical esophagus is anecdotal (20 published cases). We present a patient with an esophageal granular cell tumor that invaded trachea, thyroid and soft tissues, performing a block resection of the cervical esophagus, two tracheal rings, thyroid and prethyroid musculature. For digestive reconstruction, a free jejunum graft with microvascular anastomosis was made and tracheal reconstruction was performed using term-terminal anastomosis. The importance of the case is twofold: to contribute more casuistry, and to describe a highly complex surgical technique never indicated in this type of tumors, due to its rarely aggressive character.
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Affiliation(s)
- Mónica Miró
- Unidad de Cirugía Esofagogástrica, Servicio de Cirugía General y Digestiva, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España.
| | - Francisco Rivas
- Servicio de Cirugía Torácica, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Ana López
- Servicio de Cirugía Plástica y Reconstructiva, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Leandre Farran
- Unidad de Cirugía Esofagogástrica, Servicio de Cirugía General y Digestiva, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España
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4
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Yun XJ, Bai YH, Jing CC. Granular cell tumor of the esophagus: Report of one case and review of the Chinese literature. Shijie Huaren Xiaohua Zazhi 2019; 27:1167-1170. [DOI: 10.11569/wcjd.v27.i18.1167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Granular cell tumor (GCT) is a rare soft tissue tumor that has malignancy potential. Despite the lack of specific clinical manifestations, GCT has special gastroscopic and endoscopic ultrasonographic manifestations.
CASE SUMMARY A male patient was admitted because of epigastric pain for 20 d, and there were no positive signs of abdominal examination. Gastroscopy showed that there was a 0.5 cm × 0.7 cm submucous eminence on the right wall of the esophagus at 39 cm from the incisor, and the tumor had a yellowish and smooth surface, and was hard and movable on touch. Endoscopic ultrasonography showed that the lesion was slightly hyperechoic and originated from the submucosa. After endoscopic submucosal dissection, it was confirmed pathologically to be an esophageal GCT.
CONCLUSION Esophageal GCT is clinically rare and has specific endoscopic and pathological manifestations. Because of the malignancy potential, active endoscopic treatment is necessary. Surgical treatment is still needed for malignant lesions or lesions invading the muscle layer.
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Affiliation(s)
- Xiao-Jing Yun
- Department of Gastroenterology, The Second People's Hospital of Liaocheng, Linqing 252600, Shandong Province, China
| | - Yu-Huan Bai
- Department of Gastroenterology, The Second People's Hospital of Liaocheng, Linqing 252600, Shandong Province, China
| | - Chang-Chun Jing
- Department of Gastroenterology, The Second People's Hospital of Liaocheng, Linqing 252600, Shandong Province, China
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5
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Wang H, Tan Y, Huo J, Liu D. Submucosal 1-tunnel endoscopic resection for treating upper gastrointestinal multiple submucosal tumor originating from the muscularis propria layer: A report of 12 cases. Medicine (Baltimore) 2019; 98:e14484. [PMID: 30732218 PMCID: PMC6380810 DOI: 10.1097/md.0000000000014484] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 11/28/2018] [Accepted: 01/19/2019] [Indexed: 12/21/2022] Open
Abstract
To explore the feasibility and efficacy of submucosal 1-tunnel endoscopic resection (1-tunnel STER) for the treatment of multiple upper gastrointestinal submucosal tumors (GI-SMTs) originating from the muscularis propria (MP) layer.A total of 12 patients with multiple upper GI-SMTs (no less than 2 SMTs) who underwent 1-tunnel STER from April 2013 to October 2017 were included. Clinical data on general characteristics, operation-related parameters, adverse events, and follow-up results were recorded and analyzed.All 12 patients underwent 1-tunnel STER successfully, and the mean operation time was 92.1 ± 40.8 minutes. A total of 30 SMTs were resected, out of which 27 were in the esophagus and 3 were in the stomach. The mean diameter was 15.0 ± 8.2 mm (range, 3-38 mm). All the SMTs were resected en bloc uneventfully. The SMTs comprised 28 leiomyomas and 2 gastric stromal tumors (low risk). No recurrence was noticed during a mean follow-up of 24.9 ± 15.3 months (range, 1-52 months).One-tunnel STER may serve as a feasible and effective technique for the treatment of multiple upper GI-SMTs originating from the MP layer. A large-scale prospective study is warranted for a confirmative conclusion.
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Affiliation(s)
| | - Yuyong Tan
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jirong Huo
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Deliang Liu
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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6
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Barakat M, Kar AA, Pourshahid S, Ainechi S, Lee HJ, Othman M, Tadros M. Gastrointestinal and biliary granular cell tumor: diagnosis and management. Ann Gastroenterol 2018; 31:439-447. [PMID: 29991888 PMCID: PMC6033765 DOI: 10.20524/aog.2018.0275] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/26/2018] [Indexed: 12/14/2022] Open
Abstract
Granular cell tumors (GCTs) are generally thought to be of Schwann cell origin and are typically S-100 positive. Up to 11% of these tumors affect the gastrointestinal tract, most commonly the esophagus, colon, and stomach. While GCTs are mostly benign, malignant and metastatic GCTs have been reported. GCTs are usually found incidentally during esophagogastroduodenoscopy, colonoscopy, imaging studies or during the evaluation of non-specific symptoms. Endoscopically, they are typically yellow in appearance with intact mucosa. On endoscopic ultrasound, they usually are hypoechoic, homogenous, smooth-edged lesions that appear to originate from the submucosal layer, although other endoscopic and ultrasound appearances have been described. There is no consensus on how to treat GCT. Surgical and conservative approaches have been described in the literature. GCTs can also affect the biliary tract, where patients may be misdiagnosed with cholangiocarcinoma. We explore the epidemiology, histology, clinical presentation, diagnosis and treatment of these tumors in the gastrointestinal tract, including the pharynx, esophagus, stomach, small intestine, large intestine and the perianal region. In addition, GCTs in the biliary tract are reviewed.
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Affiliation(s)
- Mohamed Barakat
- Department of Internal Medicine, Icahn School of Medicine - Queens Hospital Center, NY (Mohamed Barakat)
| | - Abdullah Abu Kar
- Department of Internal Medicine, Albany Medical Center, Albany, NY (Abdullah Abu Kar)
| | - Seyedmohammad Pourshahid
- Department of Internal Medicine, Icahn School of Medicine - Queens Hospital Center, NY (Seyedmohammad Pourshahid)
| | - Sanaz Ainechi
- Department of Pathology, Albany Medical Center, Albany, NY (Sanaz Ainechi, Hwa Jeong Lee)
| | - Hwa Jeong Lee
- Department of Pathology, Albany Medical Center, Albany, NY (Sanaz Ainechi, Hwa Jeong Lee)
| | - Mohamed Othman
- Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine, Houston, TX (Mohamed Othman)
| | - Micheal Tadros
- Department of Internal Medicine, Division of Gastroenterology, Albany Medical Center, Albany, NY (Micheal Tadros), USA
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7
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Ofori E, Ramai D, Lui YX, Reddy M. Esophageal Granular Cell Tumor: A Case and Review of the Literature. Gastroenterology Res 2018; 10:372-375. [PMID: 29317947 PMCID: PMC5755641 DOI: 10.14740/gr898w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 09/28/2017] [Indexed: 01/15/2023] Open
Abstract
Granular cell tumors (GCTs) are rare and benign tumors that can occur at any anatomical site. GCTs are thought to originate from nerve cells, particularly Schwann cells. Their name derives from the fact that an accumulation of cytoplasmic lysosomes imparts the tumor with a granular appearance. They are most commonly observed in the oral cavity, skin and subcutaneous tissue, breast, and respiratory tract. GCTs rarely affect the gastrointestinal tract. We report a 56-year-old female with a medical history of human immunodeficiency virus, hepatitis C, and cholelithiasis, who presented with abdominal pain. Upper endoscopy revealed a 1 - 2 cm solitary yellowish appearing nodule just distal to the GE junction. Biopsy of the nodule followed by histopathology was positive for S100, but negative for pancytokeratin immunostains. PAS staining highlighted cytoplasmic granules, further supporting the diagnosis of gastrointestinal GCT.
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Affiliation(s)
- Emmanuel Ofori
- Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Academic Affiliate of The Icahn School of Medicine at Mount Sinai, Clinical Affiliate of The Mount Sinai Hospital, 121 DeKalb Avenue, Brooklyn, NY 11201, USA
| | - Daryl Ramai
- Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Academic Affiliate of The Icahn School of Medicine at Mount Sinai, Clinical Affiliate of The Mount Sinai Hospital, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.,Department of Anatomical Sciences, St. George's University School of Medicine, True Blue, Grenada, WI
| | - Ying X Lui
- Department of Pathology, The Brooklyn Hospital Center, Academic Affiliate of The Icahn School of Medicine at Mount Sinai, Clinical Affiliate of The Mount Sinai Hospital, 121 DeKalb Avenue, Brooklyn, NY 11201, USA
| | - Madhavi Reddy
- Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Academic Affiliate of The Icahn School of Medicine at Mount Sinai, Clinical Affiliate of The Mount Sinai Hospital, 121 DeKalb Avenue, Brooklyn, NY 11201, USA
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8
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Abstract
Esophageal granular cell tumor is a rare benign soft tissue tumor with malignant potential, and its histogenesis remains unclear. Since clinical manifestations lack specificity, the diagnosis depends on endoscopy, endoscopic ultrasonography, pathology and immunohistochemistry. Esophageal granular cell tumors have the potential of malignant transformation and are easily confused with leiomyoma and interstitialoma. At present, the treatment of this disease has not yet reached a consensus. This review aims to elucidate the histogenesis, clinical manifestations, diagnosis, treatment and prognosis of esophageal granular cell tumors.
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9
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Ooms H, Pelckmans PA, Van Outryve S, Driessen A, Moreels TG. Endoscopic resection of two rare esophageal tumors. J Gastrointest Cancer 2015; 46:170-4. [PMID: 25675949 DOI: 10.1007/s12029-015-9687-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Hanne Ooms
- Division of Gastroenterology and Hepatology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Antwerp, Belgium,
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10
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ZHANG MING, SUN ZEQUN, ZOU XIAOPING. Esophageal granular cell tumor: Clinical, endoscopic and histological features of 19 cases. Oncol Lett 2014; 8:551-555. [PMID: 25013469 PMCID: PMC4081371 DOI: 10.3892/ol.2014.2152] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 03/06/2014] [Indexed: 12/15/2022] Open
Abstract
Esophageal granular cell tumors (GCTs) are rare and often misdiagnosed. To demonstrate their clinicopathological features, the present study reports 19 cases and reviews the literature. There were 11 female and eight male esophageal GCT patients with a median age of 42.0 years. All the tumors were solitary. The majority of patient indications for endoscopy (89.5%) were non-specific and endoscopic therapy was performed in 17 cases with a relapse in one case after a 12-month follow-up. The endoscopic appearance of esophageal GCT was variable and the majority of tumors (80.0%) were located in the middle and lower esophageal segments. The size of the tumors ranged from 0.4 to 2 cm in diameter and the surface was white-gray, pink or yellow. Nine patients underwent an endoscopic ultrasound exam, eight of which demonstrated hypoechoic echostructures with a smooth margin and intracavity growth features. One case was derived from the muscularis propria layer with an irregular margin and intra- and extra-cavity growth features. The histological features could mimic other tumors and immunohistochemical stains are usually positive for S-100, periodic acid-Schiff, neuron-specific enolase and nestin. Three cases indicated pleomorphism and Ki-67 was locally positive. Esophageal GCTs are rare and endoscopic ultrasound features are variable. Immunohistochemical staining may aid in the diagnosis.
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Affiliation(s)
- MING ZHANG
- Gastroenterology Department, Drum Tower Hospital Affiliated Medical College of Nanjing University, Nanjing, Jiangsu 210008, P.R. China
| | - ZE-QUN SUN
- Gastroenterology Department, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei 442008, P.R. China
| | - XIAO-PING ZOU
- Gastroenterology Department, Drum Tower Hospital Affiliated Medical College of Nanjing University, Nanjing, Jiangsu 210008, P.R. China
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11
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Multifocal Synchronous Granular Cell Tumors of the Gastrointestinal Tract. ACG Case Rep J 2014; 1:193-5. [PMID: 26157873 PMCID: PMC4435316 DOI: 10.14309/crj.2014.49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 06/10/2014] [Indexed: 11/17/2022] Open
Abstract
Granular cell tumors (GCT) are rare and unusual tumors, which are usually benign and asymptomatic. Only 5-10% of cases involve the gastrointestinal tract, most commonly as singular, non-cancerous lesions in the esophagus. We report a rare case of symptomatic, multifocal, synchronous GCT involving the esophagus, stomach, and cecum.
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12
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Chen WS, Zheng XL, Jin L, Pan XJ, Ye MF. Novel diagnosis and treatment of esophageal granular cell tumor: report of 14 cases and review of the literature. Ann Thorac Surg 2013; 97:296-302. [PMID: 24140217 DOI: 10.1016/j.athoracsur.2013.08.042] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 08/07/2013] [Accepted: 08/19/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Granular cell tumors (GCT), especially in the esophagus, are rare neoplasms originating from the nervous system. There is still some controversy regarding the diagnosis and treatment of esophageal GCT. METHODS We report 14 cases of esophageal GCT diagnosed and treated from January 2004 to March 2013. Their clinical manifestations, endoscopic image, endoscopic ultrasonography (EUS) appearance, pathology, immunohistochemistry, treatment, and prognosis were reviewed. RESULTS The typical images of EUS were hypoechoic, homogenous, and smooth-edged tumors restricted to deep mucosal and submucosal layers. However, there were 2 cases with tumors invading muscular layer. Endoscopic ultrasonography was valuable to assess the tumor size, location, depth of invasion, and nature. According to EUS manifestation, 11 cases with lesions 3 cm or less in diameter without muscular layer invasion underwent endoscopic resection without complication and the other 3 cases underwent surgical resection. A new technique of submucosal tunnel endoscopic resection was performed in 3 submucosal cases with lesions ranging from 2 cm to 3 cm in diameter. All of these cases were benign and histology was necessary for differential diagnosis. CONCLUSIONS Endoscopic ultrasonography plays an important guiding role in the diagnosis and treatment of esophageal GCT. Submucosal tunnel endoscopic resection is safe and effective. Further study is needed to determine whether this technique can be expanded into other applications.
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Affiliation(s)
- Wen-shu Chen
- Department of Thoracic Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Xiao-ling Zheng
- Department of Gastrointestinal Endoscopy Center, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Long Jin
- Department of Pathology, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Xiao-jie Pan
- Department of Thoracic Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.
| | - Ming-fan Ye
- Department of Thoracic Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
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13
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Heitmiller RF, Brock MV. Benign Tumors and Cysts of the Esophagus. SHACKELFORD'S SURGERY OF THE ALIMENTARY TRACT 2013:462-477. [DOI: 10.1016/b978-1-4377-2206-2.00038-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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14
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Aoyama K, Kamio T, Hirano A, Seshimo A, Kameoka S. Granular cell tumors: a report of six cases. World J Surg Oncol 2012; 10:204. [PMID: 23021251 PMCID: PMC3502223 DOI: 10.1186/1477-7819-10-204] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 09/10/2012] [Indexed: 12/27/2022] Open
Abstract
Granular cell tumor is a soft tissue neoplasm that originates in the nervous system and arises at virtually any body site, but is mainly found in the skin, oral cavity or digestive tract. Most are benign and reportedly malignant cases are rare, occurring in only 1% or 2% of cases. We report on our findings in six patients who developed granular cell tumor in the mammary gland, esophagus, subcutaneous tissue and muscle. Of six patients, two had granular cell tumor located in the breast, two in the submucosa of the esophagus, and the other two under the skin of the left axillary cavity and in the right latissimus dorsi muscle, respectively. One of the two patients with tumor in the submucosa of the esophagus also had esophageal cancer. Patients' age ranged from 41 to 70 years (average, 59.1 years). Two patients with tumor in the submucosa of the esophagus were men, and the others were women. All of them were given a diagnosis of granular cell tumor by tissue biopsy and examination of excised specimens, but no evidence of malignancy was found. No recurrence has been noted in the patients who underwent surgical tumor removal.
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Affiliation(s)
- Kei Aoyama
- Department of Surgery II, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
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15
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Díaz-Sánchez A, Soto S, Ponferrada A, Campos R, García MO, Benito DM, Troya J, Merino B, Aldeguer M. [Granular cell tumor of the esophagus: description of an infrequent benign tumor]. GASTROENTEROLOGIA Y HEPATOLOGIA 2011; 34:454-9. [PMID: 21636174 DOI: 10.1016/j.gastrohep.2011.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Revised: 03/01/2011] [Accepted: 03/02/2011] [Indexed: 02/08/2023]
Abstract
Granular cell tumors (GCT) are infrequent tumors first described by Abrikossoff in 1926. Gastrointestinal involvement occurs in about 6% of GCT, the esophagus being the most frequent location. These tumors are usually benign and asymptomatic and are usually found incidentally when an upper gastrointestinal endoscopy is carried out for another reason, showing an isolated polyp or sessile submucosal nodule, covered by intact yellowish mucosa and with firm consistency. Endoscopic ultrasonography has significantly improved the diagnosis of these lesions. Nowadays endoscopic mucosectomy is the treatment of choice of esophageal GCT with a low frequency of complications. Histologic analysis of the surgical specimen shows specific characteristics such as positivity for S-100 protein. We present two new cases of esophageal GCT that were diagnosed recently and discuss the most relevant features of this infrequent disease.
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Affiliation(s)
- Antonio Díaz-Sánchez
- Sección de Aparato Digestivo, Hospital Universitario Infanta Leonor, Madrid, España.
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16
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Unusual finding of benign Abrikossoff tumor by F-18 FDG-PET mimicking melanoma recurrence. Clin Nucl Med 2009; 34:696-7. [PMID: 19893405 DOI: 10.1097/rlu.0b013e3181b539d2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Granular cell tumor of Abrikossoff is a rare neoplasm that may occur in a wide variety of cutaneous and visceral sites. Granular cell tumor generally shows benign behavior. However, malignant outcome with metastatic spread has also been reported. Until now, no data were available on the most useful imaging approach for diagnosis and staging. We present a case of F-18 fluorodeoxyglucose positron emission tomography in Abrikossoff tumor, suggesting that F-18 fluorodeoxyglucose positron emission tomography may have a potential role in the management of this neoplasm.
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17
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Garrido E, Marín E, González C, Juzgado D, Boixeda D, Vázquez-Sequeiros E. [Endoscopic mucosal resection of Abrikosoff's tumor of the esophagus]. GASTROENTEROLOGIA Y HEPATOLOGIA 2009; 31:572-5. [PMID: 19091245 DOI: 10.1157/13128296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Abrikosoff's tumor (AT), or granular cell tumor (GCT), is relatively rare in the gastrointestinal tract, where the most common site is the esophagus. This tumor is usually found incidentally when an upper gastrointestinal endoscopy is carried out for another reason. Endoscopically, GCT appears as a small, yellow and submucosal lesion covered by normal mucosa. Endoscopic ultrasonography shows a homogeneous hypoechoic lesion with well defined margins. The definitive diagnosis is histological. The origin of GCT is neurogenic and the tumor is composed of eosinophilic granular cytoplasm and PAS-positive cells, which show the S-100 protein on immunohistochemistry. Although GCT is usually clinically and histologically benign, some malignant cases have been reported. Consensus is lacking on the treatment and follow-up of this tumor. Currently, endoscopic mucosal resection is a safe and effective technique to treat submucosal esophageal lesions, allowing subsequent histologic analysis. We present three patients with esophageal CGT, who were definitively treated with endoscopic mucosal resection.
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Affiliation(s)
- Elena Garrido
- Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Madrid, España
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[Multifocal Abrikossoff's granular cell tumour of the oesophagus--case report]. SRP ARK CELOK LEK 2008; 136:533-7. [PMID: 19069347 DOI: 10.2298/sarh0810533r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Granular cell tumours, relatively uncommon soft tissue tumours, have been a matter of debate among pathologists regarding histogenesis for a long time. Less common locations are in the aerodigestive tract including the oesophagus. CASE OUTLINE We have recently treated a rare case, a 37-year-old male, who was admitted due to dysphagia and a painful swallow with occasional pharyngo-nasal regurgitation followed with a mild loss of weight. Standard clinical examination including X-ray chest, ECG and laboratory tests did not show pathological findings. Barium contrast oesophagography demonstrated multiple ovoid defects in the wall of the oesophagus. CT scan of the chest confirmed luminal narrowing owing to the tumour of the upper oesophagus. Upper endoscopy showed unusual multifocal nodular lesions alongside the oesophageal axis covered by smooth mucosa. A primary biopsy specimen taken from the largest nodules confirmed an unusual pathological finding of the granular cell tumour. Subtotal, transpleural oesophagectomy was performed and reconstruction was derived by long colon segment interposition through the posterior mediastinum. The postoperative course was uneventful. The operative specimen consisted of four ovoid tumours alongside the oesophagus (the greatest diameter 0.5-1.8, average 1.25). All verified tumours histologicaly consisted of a spindle-shaped or polygonal cells containing small and large eosinophilic granules and central nuclei. Most tumour cells showed strongly positive immunohistochemical staining for S-100 protein. These tumour cells were partially positive for p-53 and Ki-67. No lymph node metastases were detected histologically. CONCLUSION Multifocal granular cell tumour of the oesophagus is an unusual finding with low incidence, and rarely caused symptoms. Pathological features and multiplicity of such tumours emphasized malignant predisposition requiring surgical resection of the oesophagus.
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Abstract
The finding of a mass lesion in the upper gastrointestinal tract at endoscopy with apparent normal overlying mucosa is common. The differential diagnosis of such lesions is broad and includes those of intramural or extramural origin. Endoscopic ultrasound provides accurate imaging of subepithelial mass lesions and characterizes them according to size, echogenicity, and origin including the histologic layer if the lesion is intramural which narrows the differential diagnosis. Endoscopic ultrasound allows a guided tissue sample to be obtained for histologic confirmation which is especially important for hypoechoic lesions arising from the 3rd or 4th echogenic layers. The purpose of this article is to review the diagnosis of the more common subepithelial mass lesions with an emphasis on endoscopic ultrasound and the subsequent management or monitoring.
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Affiliation(s)
- Jeremy L Humphris
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, and University of Sydney, Sydney, New South Wales, Australia
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De Rezende L, Lucendo AJ, Alvarez-Argüelles H. Granular cell tumors of the esophagus: report of five cases and review of diagnostic and therapeutic techniques. Dis Esophagus 2007; 20:436-43. [PMID: 17760659 DOI: 10.1111/j.1442-2050.2007.00692.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Granular cell tumors (GCT) of the esophagus are stromal lesions originating from the Schwann cells of the submucosal neuronal plexus. Although they are very infrequent, they constitute the second largest cause of non-epithelial tumors in the esophagus after leiomyomas. These tumors are generally benign, although a certain number of malignant, aggressive cases have been reported. Diagnosis requires that this possibility be ruled out before deciding on which course of therapeutic action to take as well as familiarization with the relevant indicators. GCT linked synchronically or metachronically to other malignant neoplasias of the esophagus have also been described, but the actual extent of this association is uncertain. This report describes five cases of GCT recently diagnosed as incidental findings following endoscopic exploration. All of these were benign and were treated conservatively. The article discusses new aspects relating to the diagnosis of these lesions and the role carried out by endoscopic ultrasonography in their characterization, both at preliminary diagnosis and monitoring levels. No standard therapeutic guidelines exist for the management of GCT, but endoscopic treatment without invading the muscularis propria layer would be used for symptomatic patients, creating histopathological doubts requiring research on the entire organ. Endoscopic therapeutic techniques are analyzed (resection with forceps or diathermy handles, yttrium-aluminum-garnet laser ablation, alcohol injection) in esophageal GCT, which have overtaken surgery in most cases due to their efficiency, greater safety and fewer complications.
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Affiliation(s)
- L De Rezende
- Department of Gastroenterology, University Hospital of the Canary Islands, Tenerife, Spain
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Kuroda N, Kohno N, Iwamura SI, Hamaguchi N, Ohara M, Hirouchi T, Zuno K. Granular cell tumor arising metachronously in the bronchus and esophagus. APMIS 2006; 114:659-62. [PMID: 16948821 DOI: 10.1111/j.1600-0463.2006.apm_490.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We present a case of granular cell tumor (GCT) occurring in the esophagus 7 years after operation for bronchial GCT. A 59-year-old Japanese man complained of epigastralgia, and endoscopic examination of the upper digestive tract disclosed a submucosal tumor in the lower esophagus. Histological examination of the endoscopic mucosal resection of the esophageal tumor showed a proliferation of neoplastic cells with an eosinophilic and granular cytoplasm. The cytoplasm of the neoplastic cells was histochemically positive for PAS stain and immunohistochemically positive for S-100. This tumor did not fulfill any of the diagnostic criteria for malignancy at either the macroscopic or microscopic level. I believe that this is the first case of GCT occurring metachronously in the respiratory and digestive tracts. Clinicians and pathologists should bear in mind that GCT may arise metachronously in the respiratory and digestive tracts.
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Affiliation(s)
- Naoto Kuroda
- Department of Pathology and Laboratory Medicine, Kochi Red Cross Hospital, Shinhonmachi 2-chome 13-51, Kochi City, Kochi 780-8562, Japan.
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Abstract
Granular cell tumor (GCT) was described for the first time by Abrikosoff in 1926. It is a relatively rare neoplasm that may occur at many sites, but most commonly in the skin or soft tissues. The occurrence of GCT in the gastrointestinal tract is rare, accounting approximately for 8% of all tumors, among which the most common site is the esophagus, whereas gastric localization is very rare. Gastric GCTs can be solitary or, more frequently, associated with other gastrointestinal localization. Although GCTs are usually clinically and histologically benign, some malignant cases have been reported. Histologically, these tumors consist of polygonal and fusiform cells disposed in compact “nests” and immunohistochemical staining for S-100 protein supports the proposed derivation from Schwann cells. A correct preoperative diagnosis of this tumor can only be made in 50% of all patients and it is always based on endoscopic biopsy. Laparoscopic or conventional wedge resection represents the treatment of choice. In this study, the authors reported a case of a 49-year-old woman with a solitary granular cell tumor of the stomach with infiltrative pattern, successfully treated with surgical resection. A review of literature is also presented with emphasis on diagnostic criteria concerning the malignant form.
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Affiliation(s)
- Rosalia Patti
- Department of Surgical and Oncological Science, Division of General Surgery, University of Palermo, Italy
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Parfitt JR, McLean CA, Joseph MG, Streutker CJ, Al-Haddad S, Driman DK. Granular cell tumours of the gastrointestinal tract: expression of nestin and clinicopathological evaluation of 11 patients. Histopathology 2006; 48:424-30. [PMID: 16487364 DOI: 10.1111/j.1365-2559.2006.02352.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIMS Granular cell tumours (GCTs) in the gastrointestinal (GI) tract are rare, with few series reported in the literature. Nestin is a recently identified intermediate filament protein that is expressed in neuroectodermal stem cells and skeletal muscle progenitor cells and has been shown to be expressed in gastrointestinal stromal tumours (GISTs) and GI schwannomas. Herein, we describe the clinicopathological and immunohistochemical features of 11 GI GCTs, introducing nestin as an additional marker that identifies these tumours. METHODS AND RESULTS The archives of the departments of pathology at London Health Sciences Centre (London, Ontario) and St Michael's Hospital (Toronto, Ontario) were searched for GCTs occurring in the GI tract, yielding 11 cases. Histological features were assessed and immunohistochemistry was performed with S100 protein, nestin, glial fibrillary acidic protein (GFAP), CD34, desmin, CD117, and inhibin-alpha. Charts were reviewed for clinical information. Ages at diagnosis ranged from 31 to 73 years; there were six males and four females. All GCTs were solitary, six in the oesophagus, three in the caecum, one in the rectum and one perianal. Most lesions were discovered incidentally. The size of the GCTs ranged from 4 mm to 30 mm. All were submucosal, typically firm, with a white-yellow appearance. Histologically, the GCTs showed moderate cellularity, predominantly solid growth with areas of nesting. While lesional cells were mainly plump and polygonal, areas of spindling were present in several tumours, more frequently in the colorectum. Margins were circumscribed. Nuclei were round to oval, with even chromatin and small nucleoli. Mitoses were rare to absent and necrosis was absent in all cases. Staining with periodic acid-Schiff, with diastase predigestion, showed globular and diffuse positivity within the cytoplasm. Moderate to strong expression of S100 protein and nestin was observed in 11 of 11 and seven of seven tumours, respectively. GFAP, CD34, desmin, CD117 and inhibin-alpha were negative. While patients were variably managed with resection or observation, all remain clinically well, without disease progression. CONCLUSIONS Although rare, GI GCTs have characteristic clinicopathological features. Nestin may be a useful immunohistochemical marker for identifying these tumours; the presence of this persistent stem cell cytoskeletal filament within GI GCTs suggests that these lesions may arise from a multipotential stem cell in the GI tract.
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Affiliation(s)
- J R Parfitt
- Department of Pathology, London Health Sciences Centre, University of Western Ontario, London, Canada
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De Ceglie A, Gatteschi B, Blanchi S, Scotto F, Pellecchia A, Conio M. Esophageal granular cell tumor treated by endoscopic mucosal resection. A case report and review of the literature. Dig Dis Sci 2005; 50:1875-9. [PMID: 16187190 DOI: 10.1007/s10620-005-2954-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2004] [Accepted: 01/28/2005] [Indexed: 12/17/2022]
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