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

• Published in: International journal of surgery case reports Vol. 87; p. 106397
• Main Authors: Cantella, Roberto, Evola, Giuseppe, Di Stefano, Carla, Trusso Zirna, Ezio, Iudica, Marianna, Piazza, Luigi
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-10-2021; Elsevier
• Subjects: Case Report; Cecum; Endoscopic submucosal resection; Granular cell tumor; Histological diagnosis; Mini invasive surgery; Endoscopic submucosal resection; Mini invasive surgery; Case report; Histological diagnosis; Granular cell tumor; Cecum
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2021.106397

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.
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.
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.
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.
•Granular Cell Tumor (GCT) is a rare lesion with unclear histogenesis.•Visceral localizations are even more rare that skin lesions.•GCT should be distinguished from all other polypoid lesions.•GCT epidemiology is limited due to its unknown origin and rare occurrence.•Some specialists recommend a surgical resection for lesions >2–5 cm.