Multiple esophagogastric granular cell tumors

Abstract

Multiple granular cell tumors of the esophagus and the stomach found in a 53-year-old man are reported. One lesion was detected within the lower thoracic esophagus and seven lesions were detected in the stomach. The esophageal tumor was resected endoscopically, and gastrectomy was performed for the multiple gastric lesions. Histologically, the tumors consisted of spindle or polyhedral cells and the cytoplasm contained punctated eosinophilic granules with positive immunohistochemical staining for S-100 protein. The tumors were mainly located in the submucosal layer. Some tumor cells were seen in the mucosae propria and the muscularis propria. The tumor cells were only slightly positive for p53- and Ki-67-immunohistochemical stainings. Based on these findings, we diagnosed the granular cell tumors as benign. Granular cell tumor is comparatively rare in clinical practice, but a few such tumors have been seen in the digestive tract. A few cases of multiple esophagogastric granular cell tumors have also been reported in the literature.

Esophageal granular cell tumor: Clinical, endoscopic and histological features of 19 cases

“…Since the positive staining of S-100 was first reported in 1986 (21), other positive markers have also been reported, including PAS (22), neuron-specific enolase (19) and nestin (7). Negative markers, which include CD117, CD34, desmin, CK, SMA, glial fibrillary acidic protein, inhibin-α, myoglobin, fibronectin and carcinoembryonic antigen, have also been reported (7,23–25). All these markers will aid the differential diagnosis of GIST, leiomyoma and squamous cancers.…”

Esophageal Granular Cell Tumor Treated by Endoscopic Mucosal Resection. A Case Report and Review of the Literature

“…About 2.7-8.1% of GCTs occur in the digestive tract, and approximately 5-12% of these tumors are of multiple occurrence (8)(9)(10). One-third of digestive GCTs arise in the esophagus, 10% in the stomach, and rarely in the colon or rectum (11).…”

“…However, approximately 1.5-2.7% of the cases reported in the literature are considered malignant (9,14). Malignant GCTs are classified into two types: the histologically and clinically malignant type and the histologically benign but clinically malignant type (8). Large size (>4 cm), rapid growth and/or rapid recurrence after previous excision, and invasion of the adjacent tissues are reported to be more indicative of malignant behavior than the histological features would indicate (5,15).…”

Tumor esofágico de células granulares: descripción de un tumor benigno poco frecuente

“…La localización más frecuente es en el esófago distal (65-75%) 3 como en nuestros 2 casos, siendo habitualmente solitarios aunque pueden ser múlti-ples en el 10% de los pacientes y pudiendo afectar a otras áreas del tracto digestivo 8,28 . Respecto a la mayor incidencia según el sexo, los estudios no son concluyentes 3,7,29 .…”

“…Se trata de un tumor poco frecuente y ampliamente distribuido en el cuerpo humano, habiéndose descrito su aparición en la cavidad bucal (preferentemente la lengua), piel, tejido celular subcutáneo, mama, tiroides, árbol respiratorio, vía biliar, aparato genital y sistema nervioso, entre otros [3][4][5][6][7] . La afectación gastrointestinal es una de las menos frecuentes (2,7-8,1%) y puede verse afectado cualquier tramo del tubo digestivo 8 . La afectación esofágica es una de las más frecuentes constituyendo el 2% de los TCG digestivos 3 , localizándose más frecuentemente en el tercio distal 9 .…”