doiSerbia

Multifocal Abrikossoff's granular cell tumor of the oesophagus: Case report

Ranđelović Tomislav D. (Kliničko-bolnički centar 'Bežanijska kosa', Beograd)
Stojšić Zorica M. (Kliničko-bolnički centar 'Bežanijska kosa', Beograd)
Gačić Jasna M. (Kliničko-bolnički centar 'Bežanijska kosa', Beograd)
Babić Darko N. (Kliničko-bolnički centar 'Bežanijska kosa', Beograd)
Stojiljković Miodrag T. (Kliničko-bolnički centar 'Bežanijska kosa', Beograd)
Baralić Ivanka M. (Kliničko-bolnički centar 'Bežanijska kosa', Beograd)
Granić Miroslav K. (Kliničko-bolnički centar 'Bežanijska kosa', Beograd)
Ivanović Nebojša S. (Kliničko-bolnički centar 'Bežanijska kosa', Beograd)
Gačić Dragan M. (Kliničko-bolnički centar 'Bežanijska kosa', Beograd)

INTRODUCTION Granular cell tumors, relatively uncommon soft tissue tumors, have been a matter of debate among pathologists regarding histogenesis for a long time. Less common locations are in the aerodigestive tract including the oesophagus. CASE OUTLINE We have recently treated a rare case, a 37-year old male, who was admitted due to dysphagia and a painful swallow with occasional pharyngo-nasal regurgitation followed with a mild loss of weight. Standard clinical examination including X-ray chest, ECG and laboratory tests did not show pathological findings. Barium contrast oesophagography demonstrated multiple ovoid defects in the wall of the oesophagus. CT scan of the chest confirmed luminal narrowing owing to the tumor of the upper oesophagus. Upper endoscopy showed unusual multifocal nodular lesions alongside the oesophageal axis covered by smooth mucosa. A primary biopsy specimen taken from the largest nodules confirmed an unusual pathological finding of the granular cell tumor. Subtotal, transpleural oesophagectomy was performed and reconstruction was derived by long colon segment interposition through the posterior mediastinum. The postoperative course was uneventful. The operative specimen consisted of four ovoid tumors alongside the oesophagus (the greatest diameter 0.5-1.8, average 1.25). All verified tumors histologicaly consisted of a spindle-shaped or polygonal cells containing small and large eosinophilic granules and central nuclei. Most tumor cells showed strongly positive immunohistochemical staining for S-100 protein. These tumor cells were partially positive for p-53 and Ki-67. No lymph node metastases were detected histologically. CONCLUSION Multifocal granular cell tumor of the oesophagus is an unusual finding with low incidence, and rarely caused symptoms. Pathological features and multiplicity of such tumors emphasized malignant predisposition requiring surgical resection of the oesophagus.

Keywords: multifocal granular cell tumor, oesophagus, oesophagectomy