Редкий клинический случай: зернисто-клеточная опухоль пищевода (опухоль Абрикосова) у подростка

Abstract

Granular cell tumors were first described by Weber in 1854. But its muscular origin was suggested, studied in detail and differentiated by the pathologist A.I. Abrikosov in 1926. With the development of immunohistochemical analysis, a version of Abrikosov's tumor pathogenesis appeared, suggesting its origin from Schwann cells. The data obtained confirmed the presence of protein S-100, neuron-specific enolase (NSE) and CD68 in tumor cells. At present, when carrying out histochemical analysis, the expression of proteins S-100 and CD68 in tumor cells is a diagnostic criterion for Abrikosov's tumor. In treatment of granular cell tumors of the esophagus, preference is given to minimally invasive endoscopic techniques, since conservative therapy has proved to be ineffective. Considering that in most cases the tumor is benign in nature, recently many authors have recommended endoscopic resection of the mucous membrane and dissection in the submucosa. This article presents the experience of treating a child with a rare Abrikosov's tumor in the lower third of the esophagus using endoscopic technique. The clinical case described proved to be a difficult diagnostic task, since Abrikosov's tumor in the esophagus in a teenager is an extremely rare pathology with a rare localization. To remove the tumor, a non-standard endoscopic technique was chosen, which made it possible to remove the formation in a single block, that is, radically, since preoperative morphological verification was impossible. Much attention is focused on the importance of endoscopic examination in diagnostic screening and the choice of treatment tactics. This work demonstrates high efficiency and safety of endoscopic tumor removal in this localization. The use of this surgical treatment technique made it possible to radically remove the tumor and ensure a smooth course of the postoperative period. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: granular cell tumor, Abrikosov's tumor, tumor of the esophagus, esophagus, children, endoscopic treatment.