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Alagar JN, Gonzalez MF. Incidental granular cell tumor at the ileocecal junction mimicking a lymph node metastasis in a patient with history of neuroendocrine tumor of the right colon. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2024; 17:487-491. [PMID: 39802874 PMCID: PMC11711484 DOI: 10.62347/nkkq5944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2024] [Accepted: 12/01/2024] [Indexed: 01/16/2025]
Abstract
Granular cell tumors are rare neoplasms originating from Schwann cells found in various organs. GCTs are seldom reported in the gastrointestinal tract. Pre-operative detection and diagnosis of colonic GCTs is challenging since the tumors are mainly asymptomatic, small, slow-growing, and submucosal. Most of these tumors are benign in histopathology and behavior. Recently, there has been greater insight into the varying presentations and behaviors of colonic GCTs with atypical histopathologic features. To contribute, we describe a GCT (2.3 cm) at the ileocecal junction found incidentally during follow-up for an excised ileal neuroendocrine tumor in a 65-year-old woman. Our GCT had an unusual focal atypia and infiltrative behavior into the pericolonic adipose tissue without metastasizing to the lymph nodes. These features are important since GCTs have a propensity for local recurrence if incompletely excised, which could have been easily missed. Even though GCTs with atypical features have low rates of recurrence and metastasis, they require close and careful attention in the absence of specific management guidelines due to potential aggressive behavior.
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Affiliation(s)
- Jayalakshmi N Alagar
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University Philadelphia, PA 19140, USA
| | - Maria F Gonzalez
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University Philadelphia, PA 19140, USA
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Moura DB, Nunes N, Chálim Rebelo C, Côrte-Real F, Rego AC, Duarte MA. Endoscopic Submucosal Dissection of Subepithelial Lesion in the Cecum: Granular Cell Tumor. GE PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2023; 30:461-463. [PMID: 38476149 PMCID: PMC10928858 DOI: 10.1159/000527586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/03/2022] [Indexed: 03/14/2024]
Affiliation(s)
- Diogo Bernardo Moura
- Gastroenterology Department, Hospital do Divino Espírito Santo de Ponta Delgada EPER, Ponta Delgada, Portugal
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Granular Data: A Rare Submucosal Tumor of the Colon-Case Report and Review of the Literature. Dig Dis Sci 2021; 66:714-722. [PMID: 33433808 DOI: 10.1007/s10620-020-06753-x] [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] [Accepted: 11/23/2020] [Indexed: 12/09/2022]
Abstract
INTRODUCTION Granular cellular tumors are unusual lesions that can occur in the gastrointestinal tract, where they localize most commonly to the esophagus followed by the colon. AREAS COVERED We report a case of a young man with a sub-epithelial lesion of the ascending colon, removed by endoscopic submucosal dissection. Histological examination revealed a granular cellular tumor without features of malignancy. We present a systematic review of the English literature evaluating granular cellular tumors of lower gastrointestinal tract. EXPERT COMMENTARY These tumors are usually asymptomatic and discovered incidentally during endoscopy performed for other reasons. Though their histological behavior is usually benign, 1-2% are malignant. Therefore, it is important that these lesions are excised and adequately pathologically characterized.
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Leal T, Carvalho S, Costa JM. A granular cell tumor: an unusual colon polyp. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2020; 111:329. [PMID: 30561220 DOI: 10.17235/reed.2018.5918/2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We read with interest the article by Sevilla Ribota et al1 that described an unexpected finding of a granular cell tumour (GCT) of the rectum, which was removed by band ligation-assisted mucosectomy. We present a similar case of a GCT of the cecum, which was resected using a different endoscopic procedure.
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Affiliation(s)
- Tiago Leal
- Gastrenterologia, Hospital de Braga, Portugal
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A Rare Granular Cell Tumor with a Center Ulcer of the Rectum. Case Rep Gastrointest Med 2020; 2020:8563718. [PMID: 32395357 PMCID: PMC7201473 DOI: 10.1155/2020/8563718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 12/11/2019] [Indexed: 11/18/2022] Open
Abstract
We report a very rare case of granular cell tumor with a center ulcer of the rectum, which was detected in a 47-year-old man during screening colonoscopy. It is difficult to distinguish granular cell tumor from other subepithelial tumors. However, our case had a center ulcer unlike previous cases. We confirmed the diagnosis using histological and immunohistochemical examinations. In addition to our case report, we discuss the morphology, size, layer of invasion, and treatment of rectal granular cell tumors based on a literature review.
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Jobrack AD, Goel S, Cotlar AM. Granular Cell Tumor: Report of 13 Cases in a Veterans Administration Hospital. Mil Med 2018; 183:e589-e593. [PMID: 29548015 DOI: 10.1093/milmed/usx237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/20/2017] [Accepted: 01/02/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Granular cell tumors (GCTs) are of neuroectodermal origin and account for 0.5% of soft tissue tumors. They are most prevalent in African-Americans in the fourth to sixth decades, with a predilection for the head and neck regions. GCTs usually resemble more common lesions and hence are difficult to diagnose preoperatively. The tumor is readily identified on needle biopsy. Although usually benign with a malignancy rate of only 2-3%, the malignant form has a reported 3-yr mortality of 60%. MATERIALS AND METHODS Clinical records of the Gulf Coast Veterans Healthcare System were surveyed for the period 1996-2016. Thirteen cases of GCT were found and reviewed for demographics, clinical course, method of diagnosis, management, and outcome. RESULTS All patients had a solitary GCT. Eleven lesions were benign and two were atypical. Sites involved were skin (8), colon (2), larynx (1), bronchus (1), and esophagus (1) (see Table I). The two atypical lesions occurred in the skin and larynx. Skin tumors were slow-growing, painful nodules, and, except for the two with preoperative needle biopsies, were misdiagnosed as epidermal inclusion cysts, lipoma, and papillary condyloma. Two colon lesions resembling a sessile polyp and submucosal lipoma, respectively, were found on colonoscopy performed for occult blood in the stool. The bleeding was attributed to adenomatous polyps also present. An atypical laryngeal GCT, found on laryngoscopy for hoarseness, was removed by submucosal resection. A bronchial GCT, excised during bronchoscopy for atelectasis, required re-excision 3 mo later. The esophageal GCT was an incidental finding on EGD for a dilated esophagus and gastric outlet obstruction. The patient declined surgical excision and elected MRI follow-up. CONCLUSION Granular cell tumors are infrequent and usually resemble more common lesions. Although almost always benign, the malignant form has a very poor prognosis. It is important to identify GCT preoperatively by fine-needle aspiration or core needle biopsy to improve outcome.
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Affiliation(s)
- Alexander D Jobrack
- Department of Surgery, Keesler Medical Center, Keesler Air Force Base, Biloxi, MS
| | - Suman Goel
- Department of Pathology and Laboratory Medicine, Gulf Coast Veterans Health Care System, Biloxi, MS
| | - Alvin M Cotlar
- Department of Surgery, Gulf Coast Veterans Health Care System, Biloxi, MS
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Chen Y, Chen Y, Chen X, Chen L, Liang W. Colonic granular cell tumor: Report of 11 cases and management with review of the literature. Oncol Lett 2018; 16:1419-1424. [PMID: 30008819 PMCID: PMC6036509 DOI: 10.3892/ol.2018.8811] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/24/2018] [Indexed: 01/27/2023] Open
Abstract
Colonic granular cell tumors (GCTs) are rare and benign, but have malignant potential. The recent progress in endoscopic procedures and technology facilitate the diagnosis and treatment of GCTs. The present study described 11 cases of colonic GCTs diagnosed between March 2010 and April 2015, including patient clinical and histopathological features. Patients were generally asymptomatic. The most common symptoms were hematoquezia and abdominal pain. The male/female ratio was 7:4; age range was 40–67 years. Colonoscopy revealed a yellowish or white, solid and well-circumscribed tumor covered by normal mucosa. Endoscopic ultrasonography (EUS) showed a homogenous, or granular-type heterogeneous, hypoechoic solid tumor originating from the submucosal layer (8 cases) or muscularis mucosae (3 cases), with maximum diameters 0.3–3.0 cm. All patients underwent endoscopic submucosal dissection or endoscopic submucosal excavation without complication. All tumors were block removed. The mean operative time was 38 min (range, 31–50 min). Immunohistochemical analysis of all specimens confirmed the diagnosis of GCT by positive staining of S-100 protein. No recurrence or metastasis was observed during follow-up periods of 11 months to 5 years. In conclusion, colonoscopy, EUS and immunohistological examination increase the accuracy of diagnosis of GCTs. Endoscopic management is feasible and safe for GCT treatment.
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Affiliation(s)
- Yahua Chen
- Department of Gastroenterology, Affiliated Hospital of Putian University, and Affiliated Putian Hospital of Southern Medical University, Putian, Fujian 351100, P.R. China
| | - Yangyang Chen
- Department of Gastrointestinal Endoscopy, Fujian Provincial Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Xiaoqiong Chen
- Department of Gastrointestinal Endoscopy, Fujian Provincial Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Liang Chen
- Department of Gastrointestinal Endoscopy, Fujian Provincial Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Wei Liang
- Department of Gastrointestinal Endoscopy, Fujian Provincial Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
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Schreiner P, Valli P, Marques Maggio E, Bauerfeind P. Simultaneous endoscopic full-thickness resection of two synchronous colonic granular cell tumours. BMJ Case Rep 2018; 2018:bcr-2017-222223. [PMID: 29391355 PMCID: PMC5812385 DOI: 10.1136/bcr-2017-222223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2018] [Indexed: 12/20/2022] Open
Abstract
Granular cell tumours (GCTs) are rare soft tissue tumours originating from Schwann cells. Due to potential malignant transformation, complete endoscopic resection should be aimed for. We report on a 49-year-old patient with two synchronous GCTs found in the caecum and the ascending colon, respectively. Synchronous endoscopic full-thickness resection (EFTR) using an all-in-one full-thickness resection device (FTRD) was performed under propofol sedation. Completeness of resection was proven histologically. No adverse events occurred. We report safe and complete simultaneous EFTR of two synchronous colonic GCTs.
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Affiliation(s)
- Philipp Schreiner
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - Piero Valli
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | | | - Peter Bauerfeind
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
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Yang SY, Min BS, Kim WR. A Granular Cell Tumor of the Rectum: A Case Report and Review of the Literature. Ann Coloproctol 2017; 33:245-248. [PMID: 29354608 PMCID: PMC5768480 DOI: 10.3393/ac.2017.33.6.245] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 10/02/2017] [Indexed: 01/20/2023] Open
Abstract
A granular cell tumor (GCT) is an uncommon mesenchymal lesion that rarely occurs in the colon and the rectum. We describe the case of 51-year-old man with a 2-cm-sized rectal GCT 10 cm above the anal verge that was incidentally detected after a screening colonoscopy. Preoperative radiologic studies demonstrated a suspicious submucosal rectal mass with mesorectal fat infiltration, but without circumferential resection margin threatening, extramural vessel invasion, and regional lymph-node enlargement. The tumor was resected by using a transanal endoscopic operation (TEO) without immediate postoperative complications. The final pathology revealed that the tumor consisted of a GCT that had invaded the subserosa with clear margins. It had no other risk factors for malignancy according to Fanburg-Smith criteria. We systematically reviewed the English literature by using PubMed and Google Scholar. This report may be the first documented case in the literature to describe a TEO for a GCT that had invaded the subserosa in the rectum.
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Affiliation(s)
- Seung Yoon Yang
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Byung Soh Min
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Woo Ram Kim
- Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Erginel B, Akin M, Yildiz A, Alkim CA, Tanik C, Karadag CA, Sever N, Tokel M, Dokucu Aİ. The first endoscopic resection of a colonic granular cell tumor in a child. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Choi SM, Hong SG, Kang SM, Chae BG, Kim SJ, Park PK, Park HS. A case of malignant granular cell tumor in the sigmoid colon. Clin Endosc 2014; 47:197-200. [PMID: 24765605 PMCID: PMC3994265 DOI: 10.5946/ce.2014.47.2.197] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 06/24/2013] [Accepted: 06/28/2013] [Indexed: 11/14/2022] Open
Abstract
Granular cell tumor (GCT) is an uncommon, usually benign neoplasm; however, a malignant potential has been described. Malignant GCT is an extremely rare neoplasm showing rapid growth and invasion into adjacent muscles, lymph nodes, or vessels, or even distant metastasis. We recently experienced a case of a histologically benign or atypical but clinically malignant GCT, with invasion of the lymph nodes and vessels in the sigmoid colon, diagnosed by segmental colon resection with lymph node dissection. We also performed a review of relevant medical literature.
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Affiliation(s)
- Sang Myung Choi
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
| | - Seung Goun Hong
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
| | - Shin Myung Kang
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
| | - Byung Gi Chae
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
| | - Sung Jin Kim
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
| | - Pyung Kang Park
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
| | - Hyun Sung Park
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
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Kocatas A, Dural AC, Sever N, Kankaya B, Dogan M, Yegen G, Gonenc M, Bilgic BM, Bedirhan MA, Alis H. Minimal invasive endoscopic management of synchronous granular cell tumours in the colon and posterior mediastinum. J Minim Access Surg 2014; 10:34-6. [PMID: 24501507 PMCID: PMC3902556 DOI: 10.4103/0972-9941.124469] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 05/27/2013] [Indexed: 11/12/2022] Open
Abstract
Granular cell tumour (GCT), which is a rare benign soft tissue neoplasm, is mostly found in the skin and soft tissue but may develop anywhere in the body. There are less than 10 reported cases of mediastinal GCTs in the current literature. Furthermore, colonic GCTs have recently gained attention due to the increased public awareness on the importance of colonoscopy screening. We report a case of a 52-year-old woman diagnosed incidentally with synchronous GCTs of the mediastinum and the hepatic flexure on her routine screening for post-operative follow-up for status-post right modified radical mastectomy due to a T2N1M0, Stage 2B breast cancer.
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Affiliation(s)
- Ali Kocatas
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Cem Dural
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Nurten Sever
- Department of Pathology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Burak Kankaya
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Mahmut Dogan
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Gulcin Yegen
- Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Murat Gonenc
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Bilge M Bilgic
- Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mehmet Ali Bedirhan
- Department of Chest Surgery, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey
| | - Halil Alis
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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Zoccali M, Cipriani N, Fichera A, Turner JR, Krane M. Acute appendicitis secondary to a granular cell tumor of the appendix in a 19-year-old male. J Gastrointest Surg 2011; 15:1482-5. [PMID: 21533589 DOI: 10.1007/s11605-011-1536-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 04/04/2011] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Granular cell tumors are rare, usually benign, neoplasms presenting as solitary small nodules in the skin or subcutaneous tissue. Involvement of the gastrointestinal tract is unusual, particularly of the appendix, and it is characterized by indolent, submucosal lesions usually diagnosed as an incidental finding. CASE REPORT We describe the rare case of acute appendicitis secondary to a granular cell tumor of the appendix in a 19-year-old male.
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Affiliation(s)
- Marco Zoccali
- Department of Surgery, University of Chicago Medical Center, Chicago, IL, 60637, USA.
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Radaelli F, Minoli G. Granular Cell Tumors of the Gastrointestinal Tract: Questions and Answers. Gastroenterol Hepatol (N Y) 2009; 5:798-800. [PMID: 37967389 PMCID: PMC2886372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
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