Endoscopic removal of granular cell tumors

Yasuda, Ichiro; Tomita, Eiichi; Nagura, Kazuo; Nishigaki, Youichi; Yamada, Osamu; Kachi, Hideki

doi:10.1016/s0016-5107(05)80604-2

Cited by 65 publications

(56 citation statements)

References 13 publications

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“…Such an approach, however, has its associated risks of bleeding, perforation, mediastinitis, abscess, and stricture as well as the concern of anesthesia. In that respect, new therapeutic options including laser, diatherapy loop, and endoscopic resection have recently been introduced [3,4]. Laser treatment has the disadvantage of the expensive technique that is not always available, whereas the diatherapy loop has a high risk of perforation.…”

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confidence: 99%

Endoscopic resection of a large granular cell tumor of the esophagus

et al. 2000

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TECHNIQUEGranular cell tumor (GCT) is an uncommon submucosal neoplasm of uncertain etiology and histogenesis. The gastrointestinal tract is a rare site of the neoplasm and the esophagus has been described as a primary location in one third of such cases [1]. A generally accepted treatment of these lesions has not been established. There is a tendency to monitor asymptomatic patients with lesions over 10 mm in diameter by annual endoscopic examination. For larger tumors, the views concerning treatment have been changing over the years. Surgical local excision of the tumor was the standard treatment for a long period [2]. Such an approach, however, has its associated risks of bleeding, perforation, mediastinitis, abscess, and stricture as well as the concern of anesthesia. In that respect, new therapeutic options including laser, diatherapy loop, and endoscopic resection have recently been introduced [3,4]. Laser treatment has the disadvantage of the expensive technique that is not always available, whereas the diatherapy loop has a high risk of perforation. In contrary, excision by biopsy forceps, or endoscopic polypectomy, is a low cost procedure, although it is not free of risk due to incomplete removal. Yasuda et al. [3] have suggested that criteria for endoscopic removal include small size (<20 mm) and nonattachment to the macularis propria. Intratumoral polidocanol injections have been used in some instances to achieve necrosis of the submucosal neoplastic cells [5]. Our report concerns a patient with a large esophageal form successfully cured by simple endoscopic resection.A 45-year-old man came for epigastric discomfort. He complained of a 5-month, non-specific, persistent indigestion and a feeling of postprandial fullness. Symptoms were not related to eating. An upper gastrointestinal endoscopy revealed a sessile yellowish polypoid tumor in the lower esophagus, 33 cm from the incisor teeth. The tumor was of firm consistency when touched with the biopsy forceps, measured about 28 mm in diameter, and was covered with and surrounded by normal-looking mucosa. The histological findings in the biopsy were consistent with GCT, showing a diffuse thickening of the mucosa and growth of large cells with numerous fine eosinophilic granules. Surface squamous epithelium dis-*Correspondence to: Vassilis G.

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confidence: 99%

Endoscopic resection of a large granular cell tumor of the esophagus

et al. 2000

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“…The incidence of this neoplasm has not been defined, but it is supposed to affect more often men in his 40s or 50s 2 . When affecting the gastrointestinal tract, this tumor is usually located in the submucosa, covered by normal mucosa 6 . The tumor diameter varies from 1 to 2 cm, but tumors of 4 cm diameter have been reported, and it may be a single tumor or multiple tumors.…”

Section: Discussionmentioning

confidence: 99%

“…The immunohistochemical analysis confirms the diagnosis when demonstrating positivity to S-100 protein, neuron specific enolasis and vimentin, and negativity to alpha smooth muscle actin and desmin 1 . As this is a benign pathology, the recommended treatment is the endoscopic excision of the lesion by extensive biopsy when the tumor diameter is smaller than 2 cm and not adherent to the muscularis propria, preventing complications such as perforation and bleeding 6 . In cases of multiple tumors, total colostomy is recommended.…”

Section: Discussionmentioning

confidence: 99%

Granular cell tumor of colon: a case report

Brambilla¹,

Ponte²,

Bosi³

et al. 2012

J. Coloproctol. (Rio J.)

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193Brambilla E, Dal Ponte MA, Bosi HR, Capra RP, Silva PG. Granular cell tumor of colon: a case report. J Coloproctol, 2012;32(2): 193-195.ABSTRACT: Granular cell tumor rarely affects the gastrointestinal tract. The symptoms are often unspecific and the diagnosis is reached accidentally by colonoscopy. We report the case of a 42-year-old patient diagnosed with granular cell carcinoma of the colon based on an incidental finding in colonoscopy, who was treated successfully by endoscopic excision of the tumor.Keywords: colon; colonoscopy; granular cell tumor; endoscopy.RESUMO: O tumor de células granulares raramente acomete o trato gastrointestinal. Os sintomas muitas vezes são inespecíficos e o diagnós-tico é feito ao acaso através da colonoscopia. Nós reportamos o caso de um paciente de 42 anos diagnosticado com tumor de células granulares de cólon devido a um achado incidental da colonoscopia e tratado com sucesso com remoção endoscópica.

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“…For this reason, endoscopic resection is currently considered an appropriate approach for total resection of GCT [2][3][4]19] . However,various modified endoscopic therapies, such as endoscopic mucosal resection (EMR) [2] , endoscopic aspiration lumpectomy (EAL) [5] , strip biopsy [6] , endoscopic mucosal resection using a ligating device (EMRL) [4] and EUS-guided endoscopic resection using band ligation [19] have been reported. Submucosal tumors smaller than 1 cm in diameter and separate from the muscularis propria can be resected by endoscopic therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Current advances in endoscopic techniques and technology have greatly enhanced the diagnosis and treatment of gastrointestinal malignancy. Endoscopic resection can greatly improve the management of submucosal tumors (SMT) of the gastrointestinal tract [2][3][4][5][6] . SMT can be resected easily and safely using this treatment method.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic submucosal dissection for esophageal granular cell tumor using the clutch cutter

Komori¹

2012

WJGE

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Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate. The shortcomings of this method are the deficiencies of fixing the knife to the target lesion, and of compressing it. These shortcomings can lead to major complications such as perforation and bleeding. To reduce the risk of complications related to ESD, we developed a new grasping type scissors forceps (Clutch Cutter®, Fujifilm, Japan) which can grasp and incise the targeted tissue using an electrosurgical current. Esophagogastroduodenoscopy on a 59-yearold Japanese man revealed a 16mm esophageal submucosal nodule with central depression. Endoscopic ultrasonography demonstrated a hypoechoic solid tumor limited to the submucosa without lymph node involvement. The histologic diagnosis of the specimen obtained by biopsy was granular cell tumor. It was safely and accurately resected without unexpected incision by ESD using the CC. No delayed hemorrhage or perforation occurred. Histological examination confirmed that the granular cell tumor was completely excised with negative resection margin.We report herein a case of esophageal granular cell tumor successfully treated by an ESD technique using the CC.

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Endoscopic removal of granular cell tumors

Cited by 65 publications

References 13 publications

Endoscopic resection of a large granular cell tumor of the esophagus

Endoscopic resection of a large granular cell tumor of the esophagus

Granular cell tumor of colon: a case report

Endoscopic submucosal dissection for esophageal granular cell tumor using the clutch cutter

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