Endoscopic resection of granular cell tumor in the esophagus: A single center experience

Aims Granular cell tumors (GCTs) are primarily observed in the skin and oral cavity. Although GCTs are rare in the gastrointestinal tract, they have been increasingly detected owing to the increasing number of screening endoscopies. In particular, GCTs are the second most common subepithelial tumors in the esophagus. While esophageal GCTs are mostly considered benign, malignancy should be suspected in cases in which the tumor exceeds 2 cm or grows rapidly. Therefore, endoscopic resection is considered in almost all the cases. However, studies on the safety and long-term prognosis of endoscopic resection for esophageal GCTs are lacking. We aimed to investigate the endoscopic treatment outcomes of esophageal GCTs based on various endoscopic resection methods.

Methods We retrospectively analyzed the treatment outcomes of 71 esophageal GCTs in 66 patients who underwent endoscopic resection at Pusan National University Hospital from 2013 to 2023. Endoscopic resection methods included endoscopic mucosal resection (EMR), EMR with ligation device (EMR-L), and endoscopic submucosal dissection (ESD).

Results The mean age of the patients was 50.8±10.6 years, with the majority being men (62.1%). The median size of the GCTs was 6 mm (range: 3–20 mm). Most of the lesions were located in the lower esophagus (57.7%). On EUS, GCTs mainly originated from the second layer (49%) or from both the second and third layers (37.3%). Conventional EMR was performed in 6 cases (8.5%), EMR-L in 57 (80.3%), and ESD in 8 (11.3%), respectively. En bloc resection was achieved in all the cases. The histopathological complete resection rate was 83.1%. There was no statistically significant difference in complete resection rates according to resection method (conventional EMR, 6/6 [100%]; EMR-L, 46/57 [80.7%]; and ESD, 7/8 [87.5%]; P=0.458). No serious adverse events such as bleeding or perforation were observed in any case. No recurrence of was observed during the median follow-up period of 12 months (range, 5–51 months)

Conclusions Endoscopic resection of esophageal GCTs is effective and safe, regardless of the resection method.

Publication History

Article published online:
27 March 2025