Multifocal granular cell tumor presenting as an esophageal stricture

Gastric granular cell tumor: A case report and literature review

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.

A case of esophageal granular cell tumor diagnosed by mucosal incision-assisted biopsy

For an esophageal submucosal mass suspicious of granular cell tumor (GCT) based on gross appearance and endoscopic ultrasound findings, a sufficient number of biopsy specimens is required for a definite diagnosis using immunohistochemical examination. When the specimen obtained by forceps biopsy is insufficient, endoscopic ultrasound-fine needle aspiration (EUS-FNA) is believed to be an useful alternative. However, it may be difficult to obtain an adequate amount of tumor material using EUS-FNA. Mucosal incision-assisted biopsy (MIAB) is a simple method that can collect larger amounts of specimens. This procedure is helpful for physicians who encounter the problem of obtaining an adequate amount of biopsy material from esophageal tumors suspicious for GCT. We present a case of esophageal GCT that was successfully diagnosed through MIAB.

Granular cell tumor of the esophagus: Report of one case and review of the Chinese literature

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.

Progress in research of esophageal granular cell tumors

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.

Large Mid-Esophageal Granular Cell Tumor: Benign Versus Malignant

Granular cell tumors are rare soft tissue neoplasms, among which only 2% are malignant, arising from nervous tissue. Here we present a case of a large esophageal granular cell tumor with benign histopathological features which metastasized to the liver, but showing on positron emission tomography-computerized tomography standardized uptake value suggestive of a benign lesion.

Esophageal granular cell tumor: Clinical, endoscopic and histological features of 19 cases

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.

Novel diagnosis and treatment of esophageal granular cell tumor: report of 14 cases and review of the literature

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.

Surgical treatment of a rare case of granular cell tumour of the cervical oesophagus

A female patient was operated upon due to cervical oesophageal stricture induced by a tumour located just below the throat. Local excision of the tumour and reconstruction of the oesophageal wall was performed using the pre-vertebral fascia due to the presence of extensive oesophageal mucosa damage. The patient also required temporary alimentation by the gastrostomy route due to swallowing disturbances. The oesophagram depicted a contrasting airway passage without any evidence of fistula and contrast medium leakage through the oesophageal lumen. Four months after the operation, the patient did not report any issue with oral intake. The postoperative histopathological and immunohistochemical examinations provided evidence of a granular cell tumour (GCT). We believe that local excision of the tumour should always be considered in cases of tumours located close to the throat because it is less invasive than partial resection of a GCT in the oesophagus or oesophagogastrectomy.

Granular cell tumor of the cervical esophagus: case report and literature review of an unusual cause of Dysphagia

Granular cell tumors (GCT) of the head and neck are not uncommon; however, involvement of the cervical esophagus is rare. Characterized by an infiltrative growth pattern, these benign tumors are historically difficult to surgically excise and are radioresistant. We present here a case of dysphagia caused by a GCT of the cervical esophagus. Work up with ultrasound-guided fine needle aspiration was suggestive of a GCT due to the presence of cohesive cells with granular cytoplasm that were S-100 and CD68 positive with immunostaining, and PAS positive with histochemistry. Resection required removal of a portion of the muscular wall of the esophagus sparing the overlying mucosa. The patient is currently asymptomatic and without recurrence after 10 month follow-up. Review of the literature revealed 19 reports of cervical esophageal GCTs. There is a female preponderance (75%), with an average age of 41 years. Dysphagia and weight loss are the most common presenting symptoms. The average tumor size on presentation was 2.7 cm, with symptomatic tumors being significantly larger than asymptomatic lesions; the latter was present in 25% of patients. Concurrent GCTs in the upper aerodigestive tract were identified in 35% of cases. Approximately 30% of tumors required segmental cervical esophageal resection. The purpose of this report is to describe the epidemiology and treatment of GCTs of the cervical esophagus. Lesions should be addressed early with complete surgical excision to prevent growth necessitating more morbid surgery. Due to the high rate of concurrent GCTs, upper endoscopy is advised in the workup of these patients.

Endoscopic diagnosis and resection of esophageal granular cell tumors

Granular cell tumors (GCT) are uncommon neoplasms. There is controversy regarding the endoscopic diagnosis and treatment of esophageal GCT. We studied the endoscopic diagnosis and management of esophageal GCT among 23 patients identified in a single-institution pathology database. Medical records, pathology, and endoscopic images were reviewed. All patients underwent endoscopy and endoscopic ultrasonography (EUS), and endoscopic resection was performed in 10 patients. Seven of 23 patients had more than one esophageal GCT. Only six lesions exhibited a classic yellow discoloration. Among patients with a single GCT, three, four, and nine lesions were located in the proximal, middle, and distal esophagus, respectively. EUS showed hypoechoic, smooth-edged lesions usually confined to deep mucosa and submucosa. Standard forceps biopsy was diagnostic in 19 of 23 patients (83%). Ten GCT ≤ 10 mm in diameter underwent successful endoscopic mucosal resection without complication. The endoscopic appearance, location, and number of esophageal GCT are highly variable. Histological proof is still necessary for the differential diagnosis of this rare neoplasm. Endoscopic forceps biopsy is usually diagnostic. Endoscopic resection appears safe and effective in selected cases with lesions ≤ 10 mm.

[Granular cell tumor of the esophagus: description of an infrequent benign tumor]

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.