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Zylis D, Kokkali S, Sofopoulos M, Zografaki E, Vourlakou C, Skafida E. Metastatic Granular Cell Tumor: A Rare Entity. Int J Surg Pathol 2024:10668969241229347. [PMID: 38321950 DOI: 10.1177/10668969241229347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Granular cell tumor, which is thought to recapitulate a Schwann cell phenotype, is a very rare neoplasm that belongs to soft tissue tumors. It can be classified as benign, atypical or malignant, based on specific histological criteria, with the majority of cases exhibiting an indolent behavior. Its biology and clinical course are poorly understood and its optimal management is yet to be defined, given the rarity of cases. Here we describe an atypical granular cell tumor in the upper middle back skin that evolved after a thirty-year indolent period. Despite complete surgical removal, the patient experienced a recurrence, both local and in the lungs, following an aggressive clinical course. Data on management of metastatic disease are extremely scarce, comprised exclusively of case reports. Therefore, we administered to the patient systemic therapy according to soft tissue sarcoma guidelines, which led to disease progression, with fatal outcome. In conclusion, recurrent and/or metastatic granular cell tumor is a rare disease that can be life-threatening, for which response to different therapies is unknown. The biologic behavior of atypical and malignant granular cell tumor is quite different from its benign counterpart, evoking soft tissue sarcomas, and its diagnosis should alert clinicians. The role of adjuvant chemotherapy and radiation therapy in this setting should be explored, to limit disease recurrence.
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Affiliation(s)
- Dimosthenis Zylis
- First Medical Oncology Clinic, Saint-Savvas Cancer Hospital, Athens, Greece
| | - Stefania Kokkali
- First Medical Oncology Clinic, Saint-Savvas Cancer Hospital, Athens, Greece
- Oncology Unit, 2nd Department of Medicine, National and Kapodistrian University of Athens, Medical School, Hippocratio General Hospital of Athens, Athens, Greece
| | | | - Eirini Zografaki
- Department of Plastic Surgery, Saint-Savvas Cancer Hospital, Athens, Greece
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Houcine Y, Mlika M, Moussa C, Rouis H, Brahem E, Ismail O, Maȃlej S, El Mezni F. Granular cell tumor of the lung and tracheobronchial tree: Two case-presentation with a review of the literature. Rare Tumors 2023; 15:20363613231187822. [PMID: 37456799 PMCID: PMC10338731 DOI: 10.1177/20363613231187822] [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: 02/10/2023] [Accepted: 05/18/2023] [Indexed: 07/18/2023] Open
Abstract
Pulmonary granular cells tumors (CGT) are rare tumors, that derive from Schwann cells. In the tracheobronchial and pulmonary tree, they remain a diagnostic challenge. There are no well-established criteria to differentiate between benign, atypical, and malignant GCT. Moreover, its real frequency in the respiratory tract is still unknown. Here, we represent 2 cases of bronchial and lung GCTs. We aim to highlight the frequency of all clinicopathological characteristics of this rare tumor in the tracheobronchial and pulmonary tree location based on our cases and the available literature in a large systematic review.
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Affiliation(s)
- Yoldez Houcine
- Pathology Department, Abderrahmen Mami Hospital, Ariana, Tunisia
- Research Laboratory, Ariana: LR18SP06
- Faculty of Medicine of Tunis, El Manar University, Tunis
| | - Mouna Mlika
- Pathology Department, Abderrahmen Mami Hospital, Ariana, Tunisia
- Research Laboratory, Ariana: LR18SP06
- Faculty of Medicine of Tunis, El Manar University, Tunis
| | - Chirine Moussa
- Faculty of Medicine of Tunis, El Manar University, Tunis
- Pneumology Department 1, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Houda Rouis
- Faculty of Medicine of Tunis, El Manar University, Tunis
- Pneumology Department 1, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Emna Brahem
- Pathology Department, Abderrahmen Mami Hospital, Ariana, Tunisia
- Research Laboratory, Ariana: LR18SP06
| | - Olfa Ismail
- Pathology Department, Abderrahmen Mami Hospital, Ariana, Tunisia
- Research Laboratory, Ariana: LR18SP06
| | - Sonia Maȃlej
- Faculty of Medicine of Tunis, El Manar University, Tunis
- Pneumology Department 1, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Faouzi El Mezni
- Pathology Department, Abderrahmen Mami Hospital, Ariana, Tunisia
- Research Laboratory, Ariana: LR18SP06
- Faculty of Medicine of Tunis, El Manar University, Tunis
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Fan X, Jiao J, Luo L, Zhu L, Zheng Z, Chen X, Wang T, Liu W, Wang B. Role of endoscopic ultrasound and endoscopic resection in the diagnosis and treatment of esophageal granular cell tumors. Scand J Gastroenterol 2022; 57:1264-1271. [PMID: 35576559 DOI: 10.1080/00365521.2022.2067784] [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: 02/04/2023]
Abstract
BACKGROUND AND AIM Diagnosis and complete resection of esophageal granular cell tumors (GCTs) is an area of concern. However, articles on endoscopic ultrasound (EUS) and endoscopic resection of esophageal granular cell tumors are few. To evaluate the role of endoscopic ultrasound and endoscopic resection in the diagnosis and treatment of esophageal granular cell tumors. METHODS A retrospective analysis of 15 patients with esophageal granular cell tumors who underwent endoscopic ultrasound examination and endoscopic resection in our hospital was conducted. The clinical data, endoscopic ultrasound images, endoscopic treatment, pathological characteristics, postoperative complications and follow-up status of all patients were evaluated. Ten board-certified endoscopists independently evaluated the white light endoscopic images of the 15 patients (Test 1) and the endoscopic ultrasound images together with white light endoscopic images of the same patient set (Test 2). RESULT Female patients accounted for 53.4% of the participants. The average age at the time of diagnosis was 49.13 ± 9.31 years old. Ten lesions (66.67%) showed hypoechoic signal, four lesions (26.67%) showed hyperechoic signal and one lesion showed medium signal. The diagnostic accuracy was significantly higher with Test 2(65.3% vs. 92.0%, p < .001). Complete endoscopic resection was performed in all the patients. No complications occurred in any of the patients. No esophageal stenosis, recurrence, or metastases was found in all patients during the follow-up period. CONCLUSION The endoscopic ultrasound images of esophageal granular cell tumors have certain characteristics that help diagnose esophageal granular cell tumors. Endoscopic resection of esophageal granular cell tumors is an effective, safe and feasible treatment method.
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Affiliation(s)
- Xiaofei Fan
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China.,Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Jiao Jiao
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China.,Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Lili Luo
- Department of Geriatric, General Hospital, Tianjin Medical University, Tianjin, China
| | - Lanping Zhu
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China.,Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Zhongqing Zheng
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China.,Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Xin Chen
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China.,Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Tao Wang
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China.,Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Wentian Liu
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China.,Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Bangmao Wang
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China.,Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
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Reddi D, Chandler C, Cardona D, Schild M, Westerhoff M, McMullen E, Tomizawa Y, Clinton L, Swanson PE. Esophageal granular cell tumor and eosinophils: a multicenter experience. Diagn Pathol 2021; 16:49. [PMID: 34103065 PMCID: PMC8185915 DOI: 10.1186/s13000-021-01113-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/28/2021] [Indexed: 01/07/2023] Open
Abstract
Background Esophageal granular cell tumor (eGCT) is rare, and the recent literature suggests a link between eosinophilic esophagitis (EoE) and eGCT. The aim of our study was to determine if EoE or other disorders associated with eosinophilia are consistently associated with eGCT. Methods We retrospectively searched pathology databases of three academic institutions from 1999 to 2018 for eGCTs. The archived slides and medical records were reviewed. Results From 294,855 esophagogastroduodenoscopy procedures, 45 patients (17 males and 28 females) with eGCTs were identified. The patients (30–73 years in age, median 50) had eGCT 0.2–2.0 cm in size (average 0.71). Thirteen had a history of gastroesophageal reflux disease, 5 had Barrett esophagus/goblet cell metaplasia and 1 had EoE. Thirty-four eGCTs had intralesional eosinophils (14 with peak > 10 eosinophils/400x hpf); of these, 21 also had eosinophils in lamina propria (9 with peak > 10 eosinophils/hpf). eGCT with atypical features (including nuclear enlargement and prominent nucleoli) were more likely to have increased eosinophils in non-epithelial compartments than those without atypia. Pleomorphism and spindled cells were seen in 3 eGCT cases (mean peak intralesional eosinophils: 43 per hpf); 2 of these had goblet cell metaplasia. We found no association between EoE and eGCT, p = 0.5966, (95% C.I. 0.0276, 6.5389, Fisher’s exact test). Instead, most patients had gastroesophageal reflux disease or Barrett esophagus. Conclusion Eosinophilia, common in eGCT and adjacent stroma, likely drives atypical/reactive histologic features, but a pathogenic relationship between eosinophil rich inflammatory conditions and eGCT has not yet been established.
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Affiliation(s)
- Deepti Reddi
- Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Box 356100, 1959 NE Pacific St, Seattle, WA, 98195, USA.
| | - Christropher Chandler
- Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Box 356100, 1959 NE Pacific St, Seattle, WA, 98195, USA
| | - Diana Cardona
- Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Michael Schild
- Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Maria Westerhoff
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109-2800, USA
| | - Emily McMullen
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109-2800, USA
| | - Yutaka Tomizawa
- Department of Medicine, Division of Gastroenterology, University of Washington, Seattle, WA, 98195-6420, USA
| | - Lani Clinton
- Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Paul E Swanson
- Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Box 356100, 1959 NE Pacific St, Seattle, WA, 98195, USA.,Department of Medicine, Division of Gastroenterology, University of Washington, Seattle, WA, 98195-6420, USA
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