Abdelrahim Walid E, Mekki Salwa O, Ali Fatima M A, Mukhtar Sarra Ahmed H, Elssidig Kamal E, Khalil Elthir A G, Alfarog Omer
Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
Department of Histopathology, Soba University Hospital, Sudan.
J Surg Case Rep. 2019 May 28;2019(5):rjz145. doi: 10.1093/jscr/rjz145. eCollection 2019 May.
Granular cell tumors (GCTs) are rare benign tumors, which originate in the tongue, ovary, oropharynx, GIT and respiratory tract. Biliary GCTs are rarities. Clinical presentations depend on tumor site.
A 62-year-old male, presented with acute and severe abdominal pain for fifteen days. He was in pain, not pale or jaundiced. Abdominal imaging showed thick-walled gallbladder with multiple stones suggestive of calcular cholecystitis and liver cirrhosis. The diagnosis of acute-on-chronic cholecystitis was made. Following informed consent open cholecystectomy showed a cirrhotic liver with enlarged Calot's lymph node and thick adhesions. Histopathology revealed a benign GCT of the gallbladder. The patient recovered uneventfully. The patient was well with no tumor recurrence after one year follow up.
GCT of the gallbladder should be considered in patients presenting as acute-on-chronic cholecystitis without imaging evidence of tumor. Surgical removal with wide safety margins should be contemplated.
颗粒细胞瘤(GCTs)是罕见的良性肿瘤,起源于舌、卵巢、口咽、胃肠道和呼吸道。胆管颗粒细胞瘤较为罕见。临床表现取决于肿瘤部位。
一名62岁男性,出现急性剧烈腹痛15天。他感到疼痛,但无面色苍白或黄疸。腹部影像学检查显示胆囊壁增厚,伴有多个结石,提示结石性胆囊炎和肝硬化。诊断为慢性胆囊炎急性发作。在获得知情同意后,进行了开腹胆囊切除术,术中发现肝脏硬化,胆囊三角淋巴结肿大且粘连严重。组织病理学检查显示为胆囊良性颗粒细胞瘤。患者恢复顺利。随访一年,患者情况良好,无肿瘤复发。
对于表现为慢性胆囊炎急性发作且无肿瘤影像学证据的患者,应考虑胆囊颗粒细胞瘤。应考虑进行具有足够安全切缘的手术切除。