title: Yttrium-aluminum-garnet laser therapy of esophageal granular cell tumor.
abstract: BACKGROUND
  Granular cell tumor (GCT) is a rare lesion. Approximately 4% to 6% of these tumors occur in the gastrointestinal tract, one-third of them affecting the esophagus. Almost all GCTs are benign lesions. Approximately 1% to 3% are malignant. Endoscopic ultrasonography (EUS) is a diagnostic support. The best treatment for esophageal GCT is not yet clear, whether surgical excision, periodic observation, endoscopic excision, or yttrium-aluminum-garnet (YAG) laser therapy.
  
  
  METHODS
  From November 1992 to December 2000, four patients with GCTs of the esophagus were observed. All the patients underwent EUS evaluation and endoscopic YAG laser therapy of the esophageal neoplasm. At each session, a biopsy at the tumor site was obtained. The treatment was continued until endoscopic and histologic evidence of the tumor disappeared.
  
  
  RESULTS
  After the YAG laser therapy, no evidence of the tumor was found in any of the four patients with esophageal GCT. At this writing, the patients remain disease free after a mean follow-up period of 66 months. No complication has been observed. Only four sessions for each patient were necessary to eliminate the tumor.
  
  
  CONCLUSIONS
  Therapy with YAG laser was effective in all four patients with esophageal GCT, and complete necrosis of the submucosal neoplastic cells was achieved. Endoscopic YAG laser therapy appears to be a good compromise between esophageal dissection and long-term observation without tumor excision. Esophageal laser therapy is safe if correctly used, and previous EUS evaluation increases treatment safety.
authors.affiliation: Department of Surgical and Gastroenterological Sciences, Surgical Endoscopy Unit, Clinica Chirurgica 1, University of Padua, Italy. norberl@uxl.unipd.it
authors.forename: L
authors.initials: L
authors.lastname: Norberto
authors.forename: E
authors.initials: E
authors.lastname: Urso
authors.forename: I
authors.initials: I
authors.lastname: Angriman
authors.forename: R
authors.initials: R
authors.lastname: Ranzato
authors.forename: F
authors.initials: F
authors.lastname: Erroi
authors.forename: S
authors.initials: S
authors.lastname: Marino
authors.forename: S
authors.initials: S
authors.lastname: Tosato
authors.forename: C
authors.initials: C
authors.lastname: Ruffolo
authors.forename: D F
authors.initials: DF
authors.lastname: D'Amico
mesh_terms: D000328:Adult; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000532:radiotherapy*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D016586:Granular Cell Tumor / Q000532:radiotherapy*; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged