Endoscopic resection of rectal granular-cell tumor using elastic band ligation

Abstract

Granular cell tumor (GCT) is a rare neoplasm that develops in the gut's submucosal layer.We report the case of a male with a history of surgically excised colon neoplasm where a rectal polyp was identified during a followup endoscopy. The lesion, eventually identified as a GCT, was endoscopically removed by band ligation-assisted mucosectomy.This may be the second report of a colorectal GCT successfully managed using band ligation, and the first one on a rectal GCT excised with this technique.

A Rare Granular Cell Tumor with a Center Ulcer of the Rectum

“…We searched on PubMed for cases related to rectal GCT, which were published after the year 2000, using the phrase "granular cell tumor and rectum." We found only six case reports and 13 patients (Table 1) [1,[5][6][7][8][9]. Rectal GCT was more common in men than in women (ratio 12 : 2; including our patient).…”

“…However, less than 2% of them can be malignant [1]. If the tumor size is greater than 4 cm and there is ulceration, cellular necrosis, spindling, pleomorphism, increased nuclear-cytoplasmic ratio, large nucleoli, and increased mitotic activity, the potential for malignancy will be high [7,10]. Of the factors above, tumor size is the most important factor [11].…”

Granular Cell Tumor of Rectum: A Very Rare Entity

“…The mainstay of treatment for a benign GCT, as was with our patient, is endoscopic resection. Different methods of endoscopic resections (mucosal and submucosal resections) are widely used and some resections with elastic band ligation have been reported [ 17 ]. For asymptomatic and smaller tumors, endoscopic surveillance may be sufficient [ 12 ].…”