结肠颗粒细胞瘤1例并文献复习_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

张小丽 , 沈里柱 , 张鑫锋 ,  罗华友

昆明医科大学第一附属医院国家卫健委毒品依赖和戒治重点实验室/昆明医科大学第一附属医院胃肠与疝外科/昆明医科大学第一附属医院科研实验中心（昆明 650032）;

Corresponding author：

罗华友, Email: km-lhy@qq.com

Keywords：

结肠颗粒细胞瘤; 临床表现; 病理特点; 内镜治疗; 手术治疗

DOI：

10.7507/1007-9424.202012037

Video：

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目的分析结直肠颗粒细胞瘤（granular cell tumor，GCT）患者临床资料，为临床诊治结直肠 GCT 提供参考。方法报道笔者所在单位收治的 1 例结肠 GCT 患者资料，并以“colonic granular cell tumor”“rectal granular cell tumor”和“granular cell tumor”为英文关键词以及以“颗粒细胞瘤”“结肠颗粒细胞瘤”和“直肠颗粒细胞瘤” 为中文关键词，计算机检索 PubMed 数据库、CNKI 以及万方数据库 1981–2020 年期间有关 GCT 的文献，共收集到 109 例，进一步分析这 110 例 GCT 患者的临床资料。结果 GCT 的治疗方法主要有内镜下切除、全腹腔镜下切除、腹腔镜下辅助切除、开腹手术等，其中内镜下切除术为直径小于 2 cm 的 GCT 首选治疗方法；GCT 术后是否行化疗以及化疗方案选择尚无统一标准。结论多数 GCT 均可在内镜下切除，因其罕见性使得很难以制定标准的治疗方案。恶性 GCT 是一种相对化学耐药的肿瘤，根治性切除是治愈的保障。

Citation： 张小丽, 沈里柱, 张鑫锋, 罗华友. 结肠颗粒细胞瘤1例并文献复习. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(9): 1215-1218. doi: 10.7507/1007-9424.202012037 Copy

1.	Stefansson K, Wollmann RL. S-100 protein in granular cell tumors (granular cell myoblastomas). Cancer, 1982, 49(9): 1834-1838.
2.	Takaya H, Kawaratani H, Kaneko M, et al. Gastric granular cell tumor in a youth excised by endoscopic submucosal dissection : A case report and literature review. Acta Gastroenterol Belg, 2017, 80(2): 317-319.
3.	Barakat M, Kar AA, Pourshahid S, et al. Gastrointestinal and biliary granular cell tumor: diagnosis and management. Ann Gastroenterol, 2018, 31(4): 439-447.
4.	Nakachi A, Miyazato H, Oshiro T, et al. Granular cell tumor of the rectum: a case report and review of the literature. J Gastroenterol, 2000, 35(8): 631-634.
5.	Smith AR, Gilbert CF, Strausbauch P, et al. Fine needle aspiration cytology of a mediastinal granular cell tumor with histologic confirmation and ancillary studies. A case report. Acta Cytol, 1998, 42(4): 1011-1016.
6.	Endo S, Hirasaki S, Doi T, et al. Granular cell tumor occurring in the sigmoid colon treated by endoscopic mucosal resection using a transparent cap (EMR-C). J Gastroenterol, 2003, 38(4): 385-389.
7.	王志强, 孟江云, 王向东, 等. 结肠颗粒细胞瘤一例. 中华肿瘤杂志, 2000, 22(4): 282.
8.	马焕, 丁莹莹, 吕玲. 降结肠颗粒细胞瘤一例. 临床放射学杂志, 2011, 30(10): 1417-1418.
9.	王顺平, 尔丽绵, 高扬, 等. 结肠颗粒细胞瘤内镜下切除1例. 河北医科大学学报, 2012, 33(3): 278-278, 288.
10.	魏建国, 赵芳, 孙爱静. 结直肠颗粒细胞瘤7例临床病理分析. 医学研究杂志, 2014, 43(1): 64-66.
11.	杨迅, 冀明. 双镜联合切除结肠多发颗粒细胞瘤一例. 中华消化内镜杂志, 2015, 32(12): 856-857.
12.	Shrestha B, Khalid M, Gayam V, et al. Metachronous granular cell tumor of the descending colon. Gastroenterology Res, 2018, 11(4): 317-320.
13.	Soares JB, Machado A, Gonçalves R. Multiple granular cell tumor of the colon. Endoscopy, 2010, 42(Suppl 2): E158-E159.
14.	Treglia G, Mormando M, Iacovazzo D, et al. A rare case of malignant granular cell tumor of the colon incidentally detected by ¹⁸F-FDG positron emission tomography/computed tomography. Nucl Med Mol Imaging, 2013, 47(2): 148-150.
15.	Kocatas A, Dural AC, Sever N, et al. Minimal invasive endoscopic management of synchronous granular cell tumours in the colon and posterior mediastinum. J Minim Access Surg, 2014, 10(1): 34-36.
16.	Irisawa A, Hernandez LV, Bhutani MS. Endosonographic features of a granular cell tumor of the colon. J Ultrasound Med, 2001, 20(11): 1241-1243.
17.	Sultan MI, Suchi M, Werlin SL. Cecal granular cell tumor. J Pediatr Gastroenterol Nutr, 2011, 52(4): 375.
18.	Kawaura A, Nishikawa S, Tanida N, et al. Granular cell tumor of the ascending colon: a case report. Gastroenterol Jpn, 1987, 22(1): 88-91.
19.	Biscay M, Chabrun E, Menguy S, et al. Colonic Abrikossoff tumor: fortuitous discovery at colonoscopy for serrated adenomas polyposis, and resection by endoscopic submucosal dissection. Endoscopy, 2019, 51(7): E176-E178.
20.	Said Ahmad H, Mahamid M, Jawabreh Q, et al. Granular cell tumor of the colon: an exceptionally rare finding. Isr Med Assoc J, 2020, 22(2): 125-126.
21.	Take I, Shi Q, Qi ZP, et al. Endoscopic resection of colorectal granular cell tumors. World J Gastroenterol, 2015, 21(48): 13542-13547.
22.	Kandil E, Abdel Khalek M, Abdullah O, et al. Granular cell tumor arising in the right colon. Trop Gastroenterol, 2011, 32(3): 242-243.
23.	Giugliano DN, Fortuna D, Goldstein S, et al. Two separate colorectal granular cell tumors. Am Surg, 2016, 82(8): e202-e203.
24.	Bagdasaryan R, Nayak R. Granular cell tumor of ileocecal valve. Med Health R I, 2009, 92(4): 158.
25.	Kim YS, Ra JE, Sohn YW. Unusual colonic pedunculated polypoid mass covering with normal appearing colonic mucosa. Gastroenterology, 2009, 137(6): e3-e4.
26.	Lowe DL, Chaudhary AJ, Lee JR, et al. Four cases of patients with gastrointestinal granular cell tumors. South Med J, 2007, 100(3): 298-300.
27.	Ebecken R, Ebecken K, Motta RN, et al. Multiple colonic granular cell tumors. Gastrointest Endosc, 2002, 55(6): 718.
28.	Saleh H, El-Fakharany M, Frankle M. Multiple synchronous granular cell tumors involving the colon, appendix and mesentery: a case report and review of the literature. J Gastrointestin Liver Dis, 2009, 18(4): 475-478.
29.	Subramaniam S, Nagpal K, Niazi M, et al. Granular cell tumor. Am Surg, 2011, 77(4): E76-E77.
30.	Rossi GB, de Bellis M, Marone P, et al. Granular cell tumors of the colon: report of a case and review of the literature. J Clin Gastroenterol, 2000, 30(2): 197-199.
31.	Uzoaru I, Firfer B, Ray V, et al. Malignant granular cell tumor. Arch Pathol Lab Med, 1992, 116(2): 206-208.
32.	Sarsik B, Doğanavşargil B, Ozkök EE, et al. Granular cell tumor of colon. Turk J Gastroenterol, 2008, 19(1): 73-74.
33.	Johnston J, Helwig EB. Granular cell tumors of the gastrointestinal tract and perianal region: a study of 74 cases. Dig Dis Sci, 1981, 26(9): 807-816.
34.	Pareja F, Brandes AH, Basili T, et al. Loss-of-function mutations in ATP6AP1 and ATP6AP2 in granular cell tumors. Nat Commun, 2018, 9(1): 3533.
35.	Mobarki M, Dumollard JM, Dal Col P, et al. Granular cell tumor a study of 42 cases and systemic review of the literature. Pathol Res Pract, 2020, 216(4): 152865.
36.	Nie L, Xu G, Wu H, et al. Granular cell tumor of the esophagus: a clinicopathological study of 31 cases. Int J Clin Exp Pathol, 2014, 7(7): 4000-4007.
37.	Irshad A, Pope TL, Ackerman SJ, et al. Characterization of sonographic and mammographic features of granular cell tumors of the breast and estimation of their incidence. J Ultrasound Med, 2008, 27(3): 467-475.
38.	Zhong N, Katzka DA, Smyrk TC, et al. Endoscopic diagnosis and resection of esophageal granular cell tumors. Dis Esophagus, 2011, 24(8): 538-543.
39.	Guzman Rojas P, Robalino Gonzaga ES, Zayat V, et al. Benign Granular cell tumor of the cecum. Cureus, 2019, 11(2): e4074.
40.	Chen Y, Chen Y, Chen X, et al. Colonic granular cell tumor: Report of 11 cases and management with review of the literature. Oncol Lett, 2018, 16(2): 1419-1424.
41.	Sohn DK, Choi HS, Chang YS, et al. Granular cell tumor of colon: report of a case and review of literature. World J Gastroenterol, 2004, 10(16): 2452-2454.
42.	Kim BG, Song JY, Zo S, et al. S-100-negative malignant pulmonary granular cell tumor: A case report. Respir Med Case Rep, 2020, 29: 101002.
43.	Ortiz-Hidalgo C, Frías-Soria CL. The histopathology and immunohistochemistry of granular cell tumour. A study of 12 cases with a brief historical note. Rev Esp Patol, 2019, 52(1): 11-19.
44.	Rekhi B, Jambhekar NA. Morphologic spectrum, immunohistochemical analysis, and clinical features of a series of granular cell tumors of soft tissues: a study from a tertiary referral cancer center. Ann Diagn Pathol, 2010, 14(3): 162-167.
45.	Chen J, Wang L, Xu J, et al. Malignant granular cell tumor with breast metastasis: A case report and review of the literature. Oncol Lett, 2012, 4(1): 63-66.
46.	Jardines L, Cheung L, LiVolsi V, et al. Malignant granular cell tumors: report of a case and review of the literature. Surgery, 1994, 116(1): 49-54.
47.	Fanburg-Smith JC, Meis-Kindblom JM, Fante R, et al. Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol, 1998, 22(7): 779-794.
48.	Machado I, Cruz J, Lavernia J, et al. Solitary, multiple, benign, atypical, or malignant: the “Granular Cell Tumor” puzzle. Virchows Arch, 2016, 468(5): 527-538.
49.	Ohmori T, Arita N, Uraga N, et al. Malignant granular cell tumor of the esophagus. A case report with light and electron microscopic, histochemical, and immunohistochemical study. Acta Pathol Jpn, 1987, 37(5): 775-783.
50.	Wyatt MG, O’Donoghue DS, Clarke TJ, et al. Malignant granular cell tumour of the oesophagus. Eur J Surg Oncol, 1991, 17(4): 388-391.
51.	Katiyar V, Vohra I, Uprety A, et al. Recurrent unresectable malignant granular cell tumor with response to pazopanib. Cureus, 2020, 12(5): e8287.
52.	Kanat O, Yalcinkaya U, Akbunar T, et al. Gemcitabine plus paclitaxel may be a promising chemotherapy regimen for metastatic granular cell tumour. Clin Oncol (R Coll Radiol), 2008, 20(1): 93-96.
53.	Wei L, Liu S, Conroy J, et al. Whole-genome sequencing of a malignant granular cell tumor with metabolic response to pazopanib. Cold Spring Harb Mol Case Stud, 2015, 1(1): a000380.
54.	Morita S, Hiramatsu M, Sugishita M, et al. Pazopanib monotherapy in a patient with a malignant granular cell tumor originating from the right orbit: A case report. Oncol Lett, 2015, 10(2): 972-974.
55.	Conley AP, Koplin S, Caracciollo JT, et al. Dramatic response to pazopanib in a patient with metastatic malignant granular cell tumor. J Clin Oncol, 2014, 32(32): e107-e110.
56.	Imanishi J, Yazawa Y, Saito T, et al. Atypical and malignant granular cell tumors in Japan: a Japanese Musculoskeletal Oncology Group (JMOG) study. Int J Clin Oncol, 2016, 21(4): 808-816.

1. Stefansson K, Wollmann RL. S-100 protein in granular cell tumors (granular cell myoblastomas). Cancer, 1982, 49(9): 1834-1838.
2. Takaya H, Kawaratani H, Kaneko M, et al. Gastric granular cell tumor in a youth excised by endoscopic submucosal dissection : A case report and literature review. Acta Gastroenterol Belg, 2017, 80(2): 317-319.
3. Barakat M, Kar AA, Pourshahid S, et al. Gastrointestinal and biliary granular cell tumor: diagnosis and management. Ann Gastroenterol, 2018, 31(4): 439-447.
4. Nakachi A, Miyazato H, Oshiro T, et al. Granular cell tumor of the rectum: a case report and review of the literature. J Gastroenterol, 2000, 35(8): 631-634.
5. Smith AR, Gilbert CF, Strausbauch P, et al. Fine needle aspiration cytology of a mediastinal granular cell tumor with histologic confirmation and ancillary studies. A case report. Acta Cytol, 1998, 42(4): 1011-1016.
6. Endo S, Hirasaki S, Doi T, et al. Granular cell tumor occurring in the sigmoid colon treated by endoscopic mucosal resection using a transparent cap (EMR-C). J Gastroenterol, 2003, 38(4): 385-389.
7. 王志强, 孟江云, 王向东, 等. 结肠颗粒细胞瘤一例. 中华肿瘤杂志, 2000, 22(4): 282.
8. 马焕, 丁莹莹, 吕玲. 降结肠颗粒细胞瘤一例. 临床放射学杂志, 2011, 30(10): 1417-1418.
9. 王顺平, 尔丽绵, 高扬, 等. 结肠颗粒细胞瘤内镜下切除1例. 河北医科大学学报, 2012, 33(3): 278-278, 288.
10. 魏建国, 赵芳, 孙爱静. 结直肠颗粒细胞瘤7例临床病理分析. 医学研究杂志, 2014, 43(1): 64-66.
11. 杨迅, 冀明. 双镜联合切除结肠多发颗粒细胞瘤一例. 中华消化内镜杂志, 2015, 32(12): 856-857.
12. Shrestha B, Khalid M, Gayam V, et al. Metachronous granular cell tumor of the descending colon. Gastroenterology Res, 2018, 11(4): 317-320.
13. Soares JB, Machado A, Gonçalves R. Multiple granular cell tumor of the colon. Endoscopy, 2010, 42(Suppl 2): E158-E159.
14. Treglia G, Mormando M, Iacovazzo D, et al. A rare case of malignant granular cell tumor of the colon incidentally detected by ¹⁸F-FDG positron emission tomography/computed tomography. Nucl Med Mol Imaging, 2013, 47(2): 148-150.
15. Kocatas A, Dural AC, Sever N, et al. Minimal invasive endoscopic management of synchronous granular cell tumours in the colon and posterior mediastinum. J Minim Access Surg, 2014, 10(1): 34-36.
16. Irisawa A, Hernandez LV, Bhutani MS. Endosonographic features of a granular cell tumor of the colon. J Ultrasound Med, 2001, 20(11): 1241-1243.
17. Sultan MI, Suchi M, Werlin SL. Cecal granular cell tumor. J Pediatr Gastroenterol Nutr, 2011, 52(4): 375.
18. Kawaura A, Nishikawa S, Tanida N, et al. Granular cell tumor of the ascending colon: a case report. Gastroenterol Jpn, 1987, 22(1): 88-91.
19. Biscay M, Chabrun E, Menguy S, et al. Colonic Abrikossoff tumor: fortuitous discovery at colonoscopy for serrated adenomas polyposis, and resection by endoscopic submucosal dissection. Endoscopy, 2019, 51(7): E176-E178.
20. Said Ahmad H, Mahamid M, Jawabreh Q, et al. Granular cell tumor of the colon: an exceptionally rare finding. Isr Med Assoc J, 2020, 22(2): 125-126.
21. Take I, Shi Q, Qi ZP, et al. Endoscopic resection of colorectal granular cell tumors. World J Gastroenterol, 2015, 21(48): 13542-13547.
22. Kandil E, Abdel Khalek M, Abdullah O, et al. Granular cell tumor arising in the right colon. Trop Gastroenterol, 2011, 32(3): 242-243.
23. Giugliano DN, Fortuna D, Goldstein S, et al. Two separate colorectal granular cell tumors. Am Surg, 2016, 82(8): e202-e203.
24. Bagdasaryan R, Nayak R. Granular cell tumor of ileocecal valve. Med Health R I, 2009, 92(4): 158.
25. Kim YS, Ra JE, Sohn YW. Unusual colonic pedunculated polypoid mass covering with normal appearing colonic mucosa. Gastroenterology, 2009, 137(6): e3-e4.
26. Lowe DL, Chaudhary AJ, Lee JR, et al. Four cases of patients with gastrointestinal granular cell tumors. South Med J, 2007, 100(3): 298-300.
27. Ebecken R, Ebecken K, Motta RN, et al. Multiple colonic granular cell tumors. Gastrointest Endosc, 2002, 55(6): 718.
28. Saleh H, El-Fakharany M, Frankle M. Multiple synchronous granular cell tumors involving the colon, appendix and mesentery: a case report and review of the literature. J Gastrointestin Liver Dis, 2009, 18(4): 475-478.
29. Subramaniam S, Nagpal K, Niazi M, et al. Granular cell tumor. Am Surg, 2011, 77(4): E76-E77.
30. Rossi GB, de Bellis M, Marone P, et al. Granular cell tumors of the colon: report of a case and review of the literature. J Clin Gastroenterol, 2000, 30(2): 197-199.
31. Uzoaru I, Firfer B, Ray V, et al. Malignant granular cell tumor. Arch Pathol Lab Med, 1992, 116(2): 206-208.
32. Sarsik B, Doğanavşargil B, Ozkök EE, et al. Granular cell tumor of colon. Turk J Gastroenterol, 2008, 19(1): 73-74.
33. Johnston J, Helwig EB. Granular cell tumors of the gastrointestinal tract and perianal region: a study of 74 cases. Dig Dis Sci, 1981, 26(9): 807-816.
34. Pareja F, Brandes AH, Basili T, et al. Loss-of-function mutations in ATP6AP1 and ATP6AP2 in granular cell tumors. Nat Commun, 2018, 9(1): 3533.
35. Mobarki M, Dumollard JM, Dal Col P, et al. Granular cell tumor a study of 42 cases and systemic review of the literature. Pathol Res Pract, 2020, 216(4): 152865.
36. Nie L, Xu G, Wu H, et al. Granular cell tumor of the esophagus: a clinicopathological study of 31 cases. Int J Clin Exp Pathol, 2014, 7(7): 4000-4007.
37. Irshad A, Pope TL, Ackerman SJ, et al. Characterization of sonographic and mammographic features of granular cell tumors of the breast and estimation of their incidence. J Ultrasound Med, 2008, 27(3): 467-475.
38. Zhong N, Katzka DA, Smyrk TC, et al. Endoscopic diagnosis and resection of esophageal granular cell tumors. Dis Esophagus, 2011, 24(8): 538-543.
39. Guzman Rojas P, Robalino Gonzaga ES, Zayat V, et al. Benign Granular cell tumor of the cecum. Cureus, 2019, 11(2): e4074.
40. Chen Y, Chen Y, Chen X, et al. Colonic granular cell tumor: Report of 11 cases and management with review of the literature. Oncol Lett, 2018, 16(2): 1419-1424.
41. Sohn DK, Choi HS, Chang YS, et al. Granular cell tumor of colon: report of a case and review of literature. World J Gastroenterol, 2004, 10(16): 2452-2454.
42. Kim BG, Song JY, Zo S, et al. S-100-negative malignant pulmonary granular cell tumor: A case report. Respir Med Case Rep, 2020, 29: 101002.
43. Ortiz-Hidalgo C, Frías-Soria CL. The histopathology and immunohistochemistry of granular cell tumour. A study of 12 cases with a brief historical note. Rev Esp Patol, 2019, 52(1): 11-19.
44. Rekhi B, Jambhekar NA. Morphologic spectrum, immunohistochemical analysis, and clinical features of a series of granular cell tumors of soft tissues: a study from a tertiary referral cancer center. Ann Diagn Pathol, 2010, 14(3): 162-167.
45. Chen J, Wang L, Xu J, et al. Malignant granular cell tumor with breast metastasis: A case report and review of the literature. Oncol Lett, 2012, 4(1): 63-66.
46. Jardines L, Cheung L, LiVolsi V, et al. Malignant granular cell tumors: report of a case and review of the literature. Surgery, 1994, 116(1): 49-54.
47. Fanburg-Smith JC, Meis-Kindblom JM, Fante R, et al. Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol, 1998, 22(7): 779-794.
48. Machado I, Cruz J, Lavernia J, et al. Solitary, multiple, benign, atypical, or malignant: the “Granular Cell Tumor” puzzle. Virchows Arch, 2016, 468(5): 527-538.
49. Ohmori T, Arita N, Uraga N, et al. Malignant granular cell tumor of the esophagus. A case report with light and electron microscopic, histochemical, and immunohistochemical study. Acta Pathol Jpn, 1987, 37(5): 775-783.
50. Wyatt MG, O’Donoghue DS, Clarke TJ, et al. Malignant granular cell tumour of the oesophagus. Eur J Surg Oncol, 1991, 17(4): 388-391.
51. Katiyar V, Vohra I, Uprety A, et al. Recurrent unresectable malignant granular cell tumor with response to pazopanib. Cureus, 2020, 12(5): e8287.
52. Kanat O, Yalcinkaya U, Akbunar T, et al. Gemcitabine plus paclitaxel may be a promising chemotherapy regimen for metastatic granular cell tumour. Clin Oncol (R Coll Radiol), 2008, 20(1): 93-96.
53. Wei L, Liu S, Conroy J, et al. Whole-genome sequencing of a malignant granular cell tumor with metabolic response to pazopanib. Cold Spring Harb Mol Case Stud, 2015, 1(1): a000380.
54. Morita S, Hiramatsu M, Sugishita M, et al. Pazopanib monotherapy in a patient with a malignant granular cell tumor originating from the right orbit: A case report. Oncol Lett, 2015, 10(2): 972-974.
55. Conley AP, Koplin S, Caracciollo JT, et al. Dramatic response to pazopanib in a patient with metastatic malignant granular cell tumor. J Clin Oncol, 2014, 32(32): e107-e110.
56. Imanishi J, Yazawa Y, Saito T, et al. Atypical and malignant granular cell tumors in Japan: a Japanese Musculoskeletal Oncology Group (JMOG) study. Int J Clin Oncol, 2016, 21(4): 808-816.

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