Skip to main content
SpringerLink
Log in

Endoscopic resection of granular cell tumors in the gastrointestinal tract: a single center experience

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

The frequency of granular cell tumors (GCTs) identified in the gastrointestinal tract has recently increased with the increased use of routine endoscopy. Endoscopic treatment is increasingly used as an alternative to traditional surgical resection, but there are few reports on the efficacy, safety, and long-term prognosis of endoscopic treatment for GCTs. The aim of this study was to assess the efficacy, safety, and long-term prognosis of endoscopic resection for the gastrointestinal GCTs.

Methods

We examined a total of 27 GCTs in 25 patients who were treated by endoscopic resection from January 2007 to February 2011. For endoscopic resection, endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) was used.

Results

Twenty GCTs were located in the esophagus, 5 in the stomach, and 2 in the colon. The median size of the GCTs was 10 mm; the largest size, located in the ascending colon, measured 18 mm. EMR with a ligation device was performed in 20 cases, conventional EMR in 5 cases, and ESD in 2 cases. En bloc resection was performed in 25 cases (92.6 %), and endoscopic complete resection piecemeal resection was achieved in 25 cases (92.6 %). Pathologic complete resection was achieved in 22 lesions (81.5 %). Intraprocedural bleeding was noted in three patients, with no occurrence of perforation or postprocedure stricture. No recurrence was observed during the mean follow-up period of 15 months (range 9–31 months).

Conclusions

Endoscopic resection appears to be a safe and effective treatment for GCTs in the gastrointestinal tract.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Enzinger FM, Weiss SW (1988) Benign tumors of peripheral nerves. In: Enzinger FM, Weiss SW (eds) Soft tissue tumors. Mosby, St. Louis, pp 757–765

    Google Scholar 

  2. Ackerman LV, Rosai J (1989) Gastrointestinal tract. Esophagus. In: Ackerman LV, Rosai J (eds) Ackerman’s surgical pathology. Mosby, St. Louis, pp 467–486

    Google Scholar 

  3. Ackerman LV, Rosai J (1989) Soft tissues. In: Ackerman LV, Rosai J (eds) Ackerman’s surgical pathology. Mosby, St. Louis, pp 1547–1633

    Google Scholar 

  4. Palazzo L, Landi B, Cellier C, Roseau G, Chaussade S, Couturier D, Barbier J (1997) Endosonographic features of esophageal granular cell tumors. Endoscopy 29:850–853

    Article  PubMed  CAS  Google Scholar 

  5. Lack EE, Worsham GF, Callihan MD, Crawford BE, Klappenbach S, Rowden G, Chun B (1980) Granular cell tumor: a clinicopathologic study of 110 patients. J Surg Oncol 13:301–316

    Article  PubMed  CAS  Google Scholar 

  6. McSwain GR, Colpitts R, Kreutner A, O’Brien PH, Spicer S (1980) Granular cell myoblastoma. Surg Gynecol Obstet 150:703–710

    PubMed  CAS  Google Scholar 

  7. Johnston J, Helwig EB (1981) Granular cell tumors of the gastrointestinal tract and perianal region: a study of 74 cases. Dig Dis Sci 26:807–816

    Article  PubMed  CAS  Google Scholar 

  8. Goldblum JR, Rice TW, Zuccaro G, Richter JE (1996) Granular cell tumors of the esophagus: a clinical and pathologic study of 13 cases. Ann Thorac Surg 62:860–865

    Article  PubMed  CAS  Google Scholar 

  9. Yazumi S, Takahashi R, Kajiyama T, Nakase H, Watanabe N, Ohana M, Matsumoto S, Seno H, Sawada M, Uchida K, Nabeshima M, Okazaki K, Chiba T (2003) Comparison of histological analysis and endosonographic features in esophageal granular cell tumors. Dig Endosc 15:284–288

    Article  Google Scholar 

  10. Okabe H, Kanou T (1990) Usefulness of a new histologic diagnostic method “boring biopsy” in gastrointestinal submucosal tumors. Gastroenterol Endosc 32:2740–2741

    Google Scholar 

  11. Caletti G, Zani L, Bolondi L, Brocchi E, Rollo V, Barbara L (1989) Endoscopic ultrasonography in the diagnosis of gastric submucosal tumor. Gastrointest Endosc 35:413–418

    Article  PubMed  CAS  Google Scholar 

  12. Caletti GC, Brocchi E, Ferrari A, Bonora G, Santini D, Mazzoleni G, Barbara L (1991) Guillotine needle biopsy as a supplement to endosonography in the diagnosis of gastric submucosal tumors. Endoscopy 23:251–254

    Article  PubMed  CAS  Google Scholar 

  13. Kim DU, Kim GH, Ryu DY, Lee DG, Cheong JH, Lee BE, Song GA, Park do Y, Shin NR, I H, Kida M (2011) Endosonographic features of esophageal granular cell tumors using a high-frequency catheter probe. Scand J Gastroenterol 46:142–147

    Google Scholar 

  14. Shikuwa S, Matsunaga K, Osabe M, Ofukuji M, Omagari K, Mizuta Y, Takeshima F, Murase K, Otani H, Ito M, Shimokawa I, Fujii M, Kohno S (1998) Esophageal granular cell tumor treated by endoscopic mucosal resection using a ligating device. Gastrointest Endosc 47:529–532

    Article  PubMed  CAS  Google Scholar 

  15. Norberto L, Urso E, Angriman I, Ranzato R, Erroi F, Marino S, Tosato S, Ruffolo C, D’Amico DF (2002) Yttrium–aluminum-garnet laser therapy of esophageal granular cell tumor. Surg Endosc 16:361–362

    Article  PubMed  CAS  Google Scholar 

  16. Choi PM, Schneider L (1990) Endoscopic Nd:YAG laser treatment of granular cell tumor of the esophagus. Gastrointest Endosc 36:144–146

    Article  PubMed  CAS  Google Scholar 

  17. Moreira LS, Dani R (1992) Treatment of granular cell tumor of the esophagus by endoscopic injection of dehydrated alcohol. Am J Gastroenterol 87:659–661

    PubMed  CAS  Google Scholar 

  18. De Rezende L, Lucendo AJ, Alvarez-Arguelles H (2007) Granular cell tumors of the esophagus: report of five cases and review of diagnostic and therapeutic techniques. Dis Esophagus 20:436–443

    Article  PubMed  Google Scholar 

  19. Hulagu S, Senturk O, Aygun C, Gurbuz Y, Kocaman O, Celebi A, Konduk T (2007) Granular cell tumor of esophagus removed with endoscopic submucosal dissection. Turk J Gastroenterol 18:188–191

    PubMed  Google Scholar 

  20. Voskuil J, van Dijk M, Wagenaar S, van Vliet AM, Timmer R, van Hees PM (2001) Occurrence of esophageal granular cell tumors in the Netherlands between 1988 and 1994. Dig Dis Sci 46:1610–1614

    Article  PubMed  CAS  Google Scholar 

  21. Subramanyam K, Shannon CR, Patterson M, Davis M, Gourley WK (1984) Granular cell myoblastoma of the esophagus. J Clin Gastroenterol 6:113–118

    Article  PubMed  CAS  Google Scholar 

  22. Ordonez NG, Mackay B (1999) Granular cell tumor: a review of the pathology and histogenesis. Ultrastruct Pathol 23:207–222

    Article  PubMed  CAS  Google Scholar 

  23. Yamada T, Ichikawa H (1974) X-ray diagnosis of elevated lesions of the stomach. Radiology 110:79–83

    PubMed  CAS  Google Scholar 

  24. Yasuda I, Tomita E, Nagura K, Nishigaki Y, Yamada O, Kachi H (1995) Endoscopic removal of granular cell tumors. Gastrointest Endosc 41:163–167

    Article  PubMed  CAS  Google Scholar 

  25. Rubesin S, Herlinger H, Sigal H (1985) Granular cell tumors of the esophagus. Gastrointest Radiol 10:11–15

    Article  PubMed  CAS  Google Scholar 

  26. Ohmori T, Arita N, Uraga N, Tabei R, Tani M, Okamura H (1987) Malignant granular cell tumor of the esophagus. A case report with light and electron microscopic, histochemical, and immunohistochemical study. Acta Pathol Jpn 37:775–783

    PubMed  CAS  Google Scholar 

  27. Fanburg-Smith JC, Meis-Kindblom JM, Fante R, Kindblom LG (1998) Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol 22:779–794

    Article  PubMed  CAS  Google Scholar 

  28. Okahara S, Tanaka S, Haruma K (1995) A case of granular cell tumor of the esophagus resected endoscopically. J Hiroshima Med Assoc 48:810–814

    Google Scholar 

  29. Mineo TC, Biancari F, Francioni F, Trentino P, Casciani CU (1995) Conservative approach to granular cell tumour of the oesophagus: three case reports. Scand Cardiovasc J 29:141–144

    Article  CAS  Google Scholar 

  30. Coutinho DS, Soga J, Yoshikawa T, Miyashita K, Tanaka O, Sasaki K, Muto T, Shimizu T (1985) Granular cell tumors of the esophagus: a report of two cases and review of the literature. Am J Gastroenterol 80:758–762

    PubMed  CAS  Google Scholar 

  31. Maccarini MR, Michieletti G, Tampieri I, Triossi O, Bertinelli E, Casetti T (1996) Simple endoscopic treatment of a granular-cell tumor of the esophagus. Endoscopy 28:730–731

    Article  PubMed  CAS  Google Scholar 

  32. Mohammed HM, Fedail SS, Al-Hassan AM (2003) Granular cell tumor of the esophagus. Saudi Med J 24:684–685

    PubMed  Google Scholar 

  33. Hyun JH, Jeen YT, Chun HJ, Lee HS, Lee SW, Song CW, Choi JH, Um SH, Kim CD, Ryu HS (1997) Endoscopic resection of submucosal tumor of the esophagus: results in 62 patients. Endoscopy 29:165–170

    Article  PubMed  CAS  Google Scholar 

  34. Fujiwara Y, Watanabe T, Hamasaki N, Wada T, Shiba M, Uchida T, Takaishi O, Tominaga K, Higuchi K, Fukuda T, Arakawa T, Kuroki T (1999) Endoscopic resection of two granular cell tumours of the oesophagus. Eur J Gastroenterol Hepatol 11:1413–1416

    Article  PubMed  CAS  Google Scholar 

  35. Fotiadis C, Manolis EN, Troupis TG, Gorgoulis VG, Sechas MN (2000) Endoscopic resection of a large granular cell tumor of the esophagus. J Surg Oncol 75:277–279

    Article  PubMed  CAS  Google Scholar 

  36. van der Peet DL, Berends FJ, Klinkenberg-Knol EC, Cuesta MA (2001) Endoscopic treatment of benign esophageal tumors: case report of three patients. Surg Endosc 15:1489

    PubMed  Google Scholar 

  37. Kinney T, Waxman I (2003) Treatment of benign esophageal tumors by endoscopic techniques. Semin Thorac Cardiovasc Surg 15:27–34

    Article  PubMed  Google Scholar 

  38. Wehrmann T, Martchenko K, Nakamura M, Riphaus A, Stergiou N (2004) Endoscopic resection of submucosal esophageal tumors: a prospective case series. Endoscopy 36:802–807

    Article  PubMed  CAS  Google Scholar 

  39. Battaglia G, Rampado S, Bocus P, Guido E, Portale G, Ancona E (2006) Single-band mucosectomy for granular cell tumor of the esophagus: safe and easy technique. Surg Endosc 20:1296–1298

    Article  PubMed  CAS  Google Scholar 

  40. Zhong N, Katzka DA, Smyrk TC, Wang KK, Topazian M (2011) Endoscopic diagnosis and resection of esophageal granular cell tumors. Dis Esophagus 24:538–543

    Article  PubMed  CAS  Google Scholar 

  41. Endo S, Hirasaki S, Doi T, Endo H, Nishina T, Moriwaki T, Nakauchi M, Masumoto T, Tanimizu M, Hyodo I (2003) Granular cell tumor occurring in the sigmoid colon treated by endoscopic mucosal resection using a transparent cap (EMR-C). J Gastroenterol 38:385–389

    Article  PubMed  Google Scholar 

  42. Lee DG, Kim GH, Park DY, Jeong JH, Moon JY, Lee BE, Hosuk I, Song GA (2011) Endoscopic submucosal resection of esophageal subepithelial lesions using band ligation. Endoscopy 43:822–825

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Supported by a grant from the National R&D Program for Cancer Control, Ministry for Health, Welfare and Family Affairs, Republic of Korea (0920050).

Disclosures

Dong Hwahn Kahng, Gwang Ha Kim, Do Youn Park, Moo Song Jeon, Ji Won Yi, Yu Yi Choi, and Geun Am Song have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Pusan National University School of Medicine, 1-10 Ami-dong, Seo-Gu, Pusan, 602-739, Korea

    Dong Hwahn Kahng, Moo Song Jeon, Ji Won Yi, Yu Yi Choi & Geun Am Song

  2. Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, 1-10 Ami-dong, Seo-Gu, Pusan, 602-739, Korea

    Gwang Ha Kim

  3. Department of Pathology, Pusan National University School of Medicine, 1-10 Ami-dong, Seo-Gu, Pusan, 602-739, Korea

    Do Youn Park

Authors
  1. Dong Hwahn Kahng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gwang Ha Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Do Youn Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Moo Song Jeon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ji Won Yi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yu Yi Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Geun Am Song
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gwang Ha Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kahng, D.H., Kim, G.H., Park, D.Y. et al. Endoscopic resection of granular cell tumors in the gastrointestinal tract: a single center experience. Surg Endosc 27, 3228–3236 (2013). https://doi.org/10.1007/s00464-013-2899-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-013-2899-2

Keywords

Search

Navigation