Granular Cell Tumor With Cirrhosis and Transplantation

Abstract

Granular cell tumor is a rare cause of hepatic dysfunction. We report here on a patient who underwent liver transplantation for this ailment. In our literature review, the common bile duct was most commonly involved (56%). A wide variety of therapies were advanced for this type of lesion, spanning three decades of care. Twenty-eight patients (49%) had no follow-up reported, and another 2 (3%) were found at autopsy. Sixteen patients (28%) were followed more than 1 year, with 72% followed less than 1 year if at all. We present the first case of a granular cell tumor being treated with liver transplantation. Although adequate early excisional surgery should obviate the need for transplantation in these cases, widely disparate therapy and poor follow-up may mask generally inadequate therapy for this lesion. The authors recommend thorough excision and long-term follow-up for patients with this entity to avoid secondary biliary cirrhosis and to eliminate the preventable need for transplantation.

Granular Cell Tumor of the Common Hepatic Duct as an Unusual Cause of Jaundice in a Hepatitis C Patient

“…Temporary decompression can be achieved with percutaneous or endoscopic stents. 6 If left untreated, these lesions can cause luminal obstruction leading to secondary biliary cirrhosis and hepatic failure necessitating liver transplant. 2 A thorough excision is required to prevent local recurrences secondary to incomplete removal.…”

Gastrointestinal and biliary granular cell tumor: diagnosis and management

“…There are reports of patients with biliary GCTs treated with cholecystectomy, choledochoenterostomy, hepaticoenterostomy, and pancreaticoduodenectomy [ 68 ]. Treatment should be tailored to the location of the tumor and tumor-free margins are recommended to decrease the risk of recurrence [ 69 ]. These lesions can cause obstruction of the bile duct by concentric narrowing, which may lead to secondary biliary cirrhosis if left untreated, and will possibly require liver transplantation [ 69 ].…”

“…Treatment should be tailored to the location of the tumor and tumor-free margins are recommended to decrease the risk of recurrence [ 69 ]. These lesions can cause obstruction of the bile duct by concentric narrowing, which may lead to secondary biliary cirrhosis if left untreated, and will possibly require liver transplantation [ 69 ]. Based on the findings of this review, no malignant GCT of the biliary tract has been reported.…”

Posthepatischer Ikterus durch einen solitären Granularzelltumor des Ductus choledochus

“…Da es sich bei den betroffenen Patienten aufgrund der fehlenden Metastasierung infolge der Tumorbiologie meist um Solitärherde handelt, werden diese Patienten, wie auch in unserem Fallbeispiel, operiert, so dass die endgültige histologische Diagnose am Resektat gestellt wird. Selten kann es zum Auftreten multipler Granularzelltumoren in der Leber assoziiert mit einer Leberzirrhose kommen, so dass hier als Therapie nur eine Lebertransplantation hilfreich ist [14].…”