Wayne State University, Detroit, MI, USA.
J Gastrointestin Liver Dis. 2009 Dec;18(4):475-8.
A granular cell tumor (GCT) is typically a benign neural tumor of Schwann cell origin that occurs in the 4th to 6th decade of life usually as a solitary painless nodule in the dermis or subcutis. It can also be found in internal organs including the larynx, bronchus and gastrointestinal (GI) tract. Within the GI tract, it is most common in the esophagus followed by colon. Colonic GCT is mostly found incidentally during colonoscopy or surgical resection as a solitary submucosal sessile nodule, although, some may cause rectal bleeding. In this report, we describe a case of a 62 year-old woman who was found to have submucosal rectosigmoid mass at screening sigmoidoscopy. Full colonoscopy and CT-scan studies revealed multiple GCTs of the colon, appendix and the mesentery, raising the suspicion of malignant metastatic disease. However, surgical resection of all the masses in an exploratory laporatomy proved them to be benign GCTs. This case emphasizes the need to consider GCTs of the GI tract when multiple asymptomatic lesions are found incidentally in the colon before any aggressive surgical intervention is undertaken. It is also the first case of GCT involving the mesentery. A literature review of GCT of the GI tract is also provided.
颗粒细胞瘤(GCT)通常是一种起源于施万细胞的良性神经肿瘤,发生于 40 至 60 岁,通常为真皮或皮下的单个无痛性结节。它也可以在包括喉、支气管和胃肠道(GI)在内的内脏器官中发现。在胃肠道中,它最常见于食管,其次是结肠。结肠 GCT 主要在结肠镜检查或外科切除时偶然发现为单发黏膜下无蒂结节,尽管有些可能导致直肠出血。在本报告中,我们描述了一例 62 岁女性,在筛查性乙状结肠镜检查时发现直肠黏膜下肿块。全结肠镜和 CT 扫描研究显示结肠、阑尾和肠系膜有多发性 GCT,提示恶性转移性疾病。然而,剖腹探查手术切除所有肿块被证实为良性 GCT。该病例强调,在进行任何侵袭性手术干预之前,当在结肠中偶然发现多个无症状病变时,需要考虑胃肠道的 GCT。这也是首例涉及肠系膜的 GCT。我们还对胃肠道的 GCT 进行了文献复习。