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. 2021 Oct:87:106397.
doi: 10.1016/j.ijscr.2021.106397. Epub 2021 Sep 13.

Granular cell tumor of the cecum: Case report of mini invasive surgical resection and review of the literature

Roberto Cantella  1 , Giuseppe Evola  2 , Carla Di Stefano  2 , Ezio Trusso Zirna  2 , Marianna Iudica  2 , Luigi Piazza  2
Affiliations

Granular cell tumor of the cecum: Case report of mini invasive surgical resection and review of the literature

Roberto Cantella et al. Int J Surg Case Rep. 2021 Oct.

Abstract

Introduction and importance: Granular Cell Tumor (GCT) is a rare lesion with unclear histogenesis, predominantly described as a skin lesion. Visceral localization of GCT is even more rare with few cases reported in the literature. Nowadays GCT guidelines are not available.

Case presentation: A 45-year-old Caucasian woman was visited in our surgical department for significant weight loss (about 30 kg) during the previous 6 months. Colonoscopy showed a caecal polypoid lesion that was resected with a diatermic loop and classified as GCT. Microscopically, the neoplasm partially involved the mucosa and diffusely the submucosa, extending to the endoscopic resection margins. Because of the high risk of perforation during endoscopic radicalisation attempt, the patient underwent ileocecal resection. The postoperative course was uneventful.

Clinical discussion: GCT is a rare soft tissue neoplasm probably deriving from Schwann cells. The main treatment for GCT is an endoscopic mucosal/submucosal resection. Nevertheless, a radicalization of the lesion through a surgical attempt should be preferred when the endoscopic procedure is linked to a high risk of perforation. It is important to distinguish GCT from other polypoid lesions of the colon, due to its malignant potential (about 2%) and its relapsing capacity when margins are involved.

Conclusion: GTC is a rare neoplasm and as its diagnosis is made only histologically, it should be included in differential diagnosis of colonic polypoid lesions. Surgery can be considered the best choice when an endoscopic attempt of GCT lesions is linked to a high risk of colon perforation.

Keywords: Case report; Cecum; Endoscopic submucosal resection; Granular cell tumor; Histological diagnosis; Mini invasive surgery.

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Conflict of interest statement

All the authors certify that there is no conflict of interest regarding the material discussed in the manuscript.

Figures

Fig. 1
Fig. 1
Lesion identified during endoscopic exam.
Fig. 2
Fig. 2
Clips apposition after diathermic loop during endoscopic procedure.
Fig. 3
Fig. 3
a Photomicrograph section of colonic granular cell tumor (hematoxylin and eosin, original magnification ×40). b Immunohistochemical analysis revealed positive staining of S 100 in the nucleus and cytoplasm (original magnification ×40).
Fig. 4
Fig. 4
Identification site of lesion in laparoscopy.
See this image and copyright information in PMC

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