A case report of Abrikossoff`s tumor of cecum treated by endoscopic submucosal dissection

Abstract

Introduction. Granular cell tumor (GCT, synonym – Abrikossoff’s tumor) is a benign neoplasm of neuroectodermal differentiation from epithelioid cells originating from Schwann’s cells, with a characteristic sign of the presence of lysosomal granules in the cytoplasm. 5–10% of GCTs are found in the gastrointestinal tract, with the most frequent localization in the esophagus, large intestine (the right colon) and perianal zone. Most often, the tumor occurs at the age of 40–60 years, in women. As a rule, the tumor is single, but it can be multiple and associated with various hereditary syndromes, in particular, type 1 neurofibromatosis. A rare malignant variant of GCT with local spread and the possibility of metastasis has been described. At the moment, less than 100 clinical cases with tumor localization in the cecum have been described.Clinical case. A 36-year-old patient with nonspecific complaints of constipation and recurrent abdominal pain during diagnostic colonoscopy a submucosal formation in the cecum up to 1 cm in diameter, dense, fixed in the submucosa, with an unchanged mucous membrane above it was revealed. A biopsy was taken, in which a granular cell tumor was suspected. The tumor was removed by the endoscopic submucosal dissection, and the subsequent morphological and immunohistochemical studies, which confirmed a granular cell tumor (Abrikossoff’s tumor).Conclusion. Granular cell tumor of the colon is a rare, non-specific tumor that can be detected during routine diagnostic endoscopic examination. The diagnosis of GCT is established by morphological examination and immunophenotyping of the removed neoplasm. Removal of the tumor by the endoscopic submucosal dissection can be a radical method of treatment for patients with GCT in the colon.