Cantella Roberto, Evola Giuseppe, Di Stefano Carla, Trusso Zirna Ezio, Iudica Marianna, Piazza Luigi
General and Emergency Surgery Department, Garibaldi Hospital, Piazza Santa Maria di Gesù 5, 95100 Catania, Italy.
General and Emergency Surgery Department, Garibaldi Hospital, Piazza Santa Maria di Gesù 5, 95100 Catania, Italy.
Int J Surg Case Rep. 2021 Oct;87:106397. doi: 10.1016/j.ijscr.2021.106397. Epub 2021 Sep 13.
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.
颗粒细胞瘤（GCT）是一种组织发生不明的罕见病变，主要表现为皮肤病变。GCT发生于内脏的情况更为罕见，文献报道的病例较少。目前尚无GCT的诊疗指南。
一名45岁的白种女性因过去6个月体重显著减轻（约30千克）前来我院外科就诊。结肠镜检查发现盲肠有一个息肉样病变，用热活检钳切除后病理诊断为GCT。显微镜下，肿瘤部分累及黏膜，弥漫性侵犯黏膜下层，延伸至内镜切除边缘。由于内镜下根治性切除有较高的穿孔风险，该患者接受了回盲部切除术。术后恢复顺利。
GCT是一种罕见的软组织肿瘤，可能起源于施万细胞。GCT的主要治疗方法是内镜下黏膜/黏膜下切除术。然而，当内镜手术有较高的穿孔风险时，通过手术进行病变根治更为可取。由于GCT有恶变潜能（约2%）且病变边缘受累时有复发可能，因此将其与结肠其他息肉样病变相鉴别很重要。
GTC是一种罕见肿瘤，因其诊断仅依靠组织学检查，故应列入结肠息肉样病变的鉴别诊断中。当内镜下治疗GCT病变有较高的结肠穿孔风险时，手术可被认为是最佳选择。
