Clin Endosc.  2014 Mar;47(2):197-200. 10.5946/ce.2014.47.2.197.

A Case of Malignant Granular Cell Tumor in the Sigmoid Colon

• Choi SM
• Hong SG
• Kang SM
• Chae BG
• Kim SJ
• Park PK
• Park HS

• KMID: 2049010
• DOI: http://doi.org/10.5946/ce.2014.47.2.197

Abstract

Granular cell tumor (GCT) is an uncommon, usually benign neoplasm; however, a malignant potential has been described. Malignant GCT is an extremely rare neoplasm showing rapid growth and invasion into adjacent muscles, lymph nodes, or vessels, or even distant metastasis. We recently experienced a case of a histologically benign or atypical but clinically malignant GCT, with invasion of the lymph nodes and vessels in the sigmoid colon, diagnosed by segmental colon resection with lymph node dissection. We also performed a review of relevant medical literature.

Keyword

Granular cell tumor; Malignant; Sigmoid colon; Colon

MeSH Terms

Colon
Colon, Sigmoid*
Granular Cell Tumor*
Lymph Node Excision
Lymph Nodes
Muscles
Neoplasm Metastasis

Figure

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  Fig. 1 Colonoscopic findings. (A) An approximately 1-cm yellowish round submucosal tumor was observed in the sigmoid colon. (B) Follow-up colonoscopy 1 year later showed that the submucosal mass increased in size to approximately 3 cm.

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  Fig. 2 Endoscopic ultrasound findings. An approximately 1×1-cm heterogeneous hypoechoic tumor with well-demarcated border (arrows) was found on the submucosal layer.

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  Fig. 3 Pathologic findings. (A) Gross findings after segmental colon resection revealed that the mass was well circumscribed and located at the submucosal and muscular layers with central infiltration of the serosa. Histologic examination showed (B) proliferation of large polygonal cells with abundant eosinophilic granular cytoplasm and vascular invasion of tumor cells (thick arrows) (H&E stain, ×200), (C) perinodal lymphatic invasion of tumor cells (thin arrows) (H&E stain, ×100), and (D) immunohistochemical positivity for S-100 protein (S-100 protein, ×40).

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