Revia Richard A, Shah Raj, Mandalia Amar, Parikh Jignesh, Zayat Vania
Pathology, University of Central Florida College of Medicine, Orlando, USA.
Internal Medicine, University of Central Florida Hospital Corporation of America (HCA) Healthcare Graduate Medical Education, Orlando, USA.
Cureus. 2023 Jul 13;15(7):e41846. doi: 10.7759/cureus.41846. eCollection 2023 Jul.
Granular cell tumors (GCTs) are rare, typically benign, solitary neoplasms that can arise throughout the body, with reports of cases in the tongue, esophagus, colon, skin, vulva, and skeletal muscle, among others. Although GCTs are usually asymptomatic, esophageal GCTs can grow large enough to cause dysphagia. When developing the differential diagnosis for dysphagia, a broad consideration includes routine etiologies such as esophageal strictures, eosinophilic esophagitis, carcinoma, webs and rings, achalasia, and motility disorders, but GCTs may not readily come to mind. Due to their scarcity, this case report is presented to raise awareness of esophageal GCTs and emphasize key goals for diagnosing and managing this uncommon yet treatable cause of dysphagia. This case report details the clinical course of a patient presenting with a chief complaint of difficulty swallowing that was found to be caused by a subepithelial esophageal tumor discovered with esophagogastroduodenoscopy (EGD) and endoscopic ultrasound (EUS). Histopathological studies paired with immunohistochemical investigations of a tissue biopsy confirmed the etiology of the offending esophageal mass to be a GCT. The patient's dysphagia resolved after endoscopic mucosal resection of the GCT, and follow-up evaluations have remained negative for recurrence. This case highlights the esophageal GCT as an uncommon source of dysphagia and the need for EGD and EUS evaluations of subepithelial esophageal lesions accompanied by histopathological analysis for a definitive diagnosis of GCT.
颗粒细胞瘤(GCTs)是一种罕见的、通常为良性的孤立性肿瘤,可发生于全身各处,有报道称其病例出现在舌、食管、结肠、皮肤、外阴和骨骼肌等部位。尽管颗粒细胞瘤通常无症状,但食管颗粒细胞瘤可能长得足够大而导致吞咽困难。在制定吞咽困难的鉴别诊断时,广泛的考虑因素包括常规病因,如食管狭窄、嗜酸性食管炎、癌、食管蹼和环、贲门失弛缓症以及动力障碍,但颗粒细胞瘤可能不容易被想到。由于其罕见性,本文报告此病例以提高对食管颗粒细胞瘤的认识,并强调诊断和处理这种导致吞咽困难的罕见但可治疗病因的关键目标。本病例报告详细描述了一名以吞咽困难为主诉的患者的临床病程,该患者经食管胃十二指肠镜检查(EGD)和内镜超声检查(EUS)发现食管上皮下肿瘤,组织活检的组织病理学研究与免疫组化检查证实该食管肿物的病因是颗粒细胞瘤。该患者在颗粒细胞瘤经内镜黏膜切除术后吞咽困难得以缓解,随访评估未发现复发迹象。本病例突出了食管颗粒细胞瘤作为吞咽困难的罕见病因,以及对食管上皮下病变进行EGD和EUS评估并结合组织病理学分析以明确诊断颗粒细胞瘤的必要性。