Granular cell tumor of rectal submucosa: case report

Abstract

This is a case report of granular cell tumor of rectal submucosa in a female, 35-years-old patient complaining of hematochezia. We describe the histological and immunohistochemical features of the lesion responsible by this clinical find. Following that, we present a discussion of the case based on the literature review, which allowed to proving the infrequency of the tumor in the rectal area and confirms the benign nature of the tumor in this case.

A rare case of perianal granular cell tumor: case report and literature review

“…In 1926, Abrikossoff reported the first five cases of GCT with three of five being localized to the tongue. Abrikossoff postulated that the tumor arose from an embryonic muscle cell, specifically degenerating striated muscle, and identified the tumor as a myoblastic myoma [ 1 , 6 ]. In 1939, Leroux and Delarue postulated that GCT was not myogenic in origin, but a non-neoplastic accumulation of granular histocytes.…”

“…Although the majority of cases are asymptomatic, Johnston et al reported that perianal GCT is more likely to present with perianal discomfort and hematochezia than other sites [ 3 , 9 ]. Females have a 1.5:1 greater prevalence than males and presents between the fourth and sixth decade of life with an equal prevalence among all races [ 2 , 4 , 6 , 10 ]. Yamada et al found that the most important predicting factor for malignancy is size, followed by atypical histology [ 4 , 6 , 8 ].…”

“…Females have a 1.5:1 greater prevalence than males and presents between the fourth and sixth decade of life with an equal prevalence among all races [ 2 , 4 , 6 , 10 ]. Yamada et al found that the most important predicting factor for malignancy is size, followed by atypical histology [ 4 , 6 , 8 ]. Benign lesions are often less than 3 cm and have uniform nuclei with the absence of mitotic figures, whereas, a lesions greater than 4 cm were found in 60% of malignant cases [ 4 , 8 ].…”

“…Benign lesions are often less than 3 cm and have uniform nuclei with the absence of mitotic figures, whereas, a lesions greater than 4 cm were found in 60% of malignant cases [ 4 , 8 ]. Histological findings in benign and malignant lesions are identical; however, malignant cells can rarely demonstrate cellular necrosis, pleomorphism, enlarged nucleoli, cell elongation, increased nuclear-to-cytoplasmic ratio and mitotic activity [ 3 , 6 , 9 ]. Fanburg-Smith et al postulated the presence of three or more of these factors that indicate likely metastasis [ 4 ].…”

“…Fanburg-Smith et al postulated the presence of three or more of these factors that indicate likely metastasis [ 4 ]. Metastases are more common with reocurrence of a previously benign lesion spreading via lymphatic or hematogenous dissemination to the lung, liver, bone and lymph nodes [ 6 , 9 ].…”