title: Novel diagnosis and treatment of esophageal granular cell tumor: report of 14 cases and review of the literature.
abstract: BACKGROUND
  Granular cell tumors (GCT), especially in the esophagus, are rare neoplasms originating from the nervous system. There is still some controversy regarding the diagnosis and treatment of esophageal GCT.
  
  
  METHODS
  We report 14 cases of esophageal GCT diagnosed and treated from January 2004 to March 2013. Their clinical manifestations, endoscopic image, endoscopic ultrasonography (EUS) appearance, pathology, immunohistochemistry, treatment, and prognosis were reviewed.
  
  
  RESULTS
  The typical images of EUS were hypoechoic, homogenous, and smooth-edged tumors restricted to deep mucosal and submucosal layers. However, there were 2 cases with tumors invading muscular layer. Endoscopic ultrasonography was valuable to assess the tumor size, location, depth of invasion, and nature. According to EUS manifestation, 11 cases with lesions 3 cm or less in diameter without muscular layer invasion underwent endoscopic resection without complication and the other 3 cases underwent surgical resection. A new technique of submucosal tunnel endoscopic resection was performed in 3 submucosal cases with lesions ranging from 2 cm to 3 cm in diameter. All of these cases were benign and histology was necessary for differential diagnosis.
  
  
  CONCLUSIONS
  Endoscopic ultrasonography plays an important guiding role in the diagnosis and treatment of esophageal GCT. Submucosal tunnel endoscopic resection is safe and effective. Further study is needed to determine whether this technique can be expanded into other applications.
authors.affiliation: Department of Thoracic Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Wen-shu
authors.initials: WS
authors.lastname: Chen
authors.affiliation: Department of Gastrointestinal Endoscopy Center, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Xiao-ling
authors.initials: XL
authors.lastname: Zheng
authors.affiliation: Department of Pathology, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Long
authors.initials: L
authors.lastname: Jin
authors.affiliation: Department of Thoracic Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China. Electronic address: doctorpxj@163.com.
authors.forename: Xiao-jie
authors.initials: XJ
authors.lastname: Pan
authors.affiliation: Department of Thoracic Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Ming-fan
authors.initials: MF
authors.lastname: Ye
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D018572:Disease-Free Survival; D019160:Endosonography / Q000379:methods*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D016586:Granular Cell Tumor / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D018570:Risk Assessment; D012494:Sampling Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: 7