Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 28, 2015; 21(48): 13542-13547
Published online Dec 28, 2015. doi: 10.3748/wjg.v21.i48.13542
Endoscopic resection of colorectal granular cell tumors
Iri Take, Qiang Shi, Zhi-Peng Qi, Shi-Lun Cai, Li-Qing Yao, Ping-Hong Zhou, Yun-Shi Zhong
Iri Take, Qiang Shi, Zhi-Peng Qi, Shi-Lun Cai, Li-Qing Yao, Ping-Hong Zhou, Yun-Shi Zhong, Endoscopy Center, Zhongshan Hospital of Fudan University, Shanghai 200032, China
Iri Take, Qiang Shi, Zhi-Peng Qi, Shi-Lun Cai, Li-Qing Yao, Ping-Hong Zhou, Yun-Shi Zhong, Endoscopy Research Institute of Fudan University, Shanghai 200032, China
Author contributions: Take I, Shi Q and Qi ZP contributed equally to this work; Take I and Qi ZP collected the data; Take I analyzed and drafted the manuscript; Shi Q designed and supervised the study; Cai SL, Zhou PH and Yao LQ revised the manuscript for important intellectual content; Yao LQ, Zhou PH and Zhong YS provided administrative support; all authors have read and approved the final version to be published.
Supported by The Open Fund for Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education at Fudan University, No. KLCCI2014-6; and the Shanghai Municipal Science and Technology Committee (13DZ1940402, 13411950800, 13411951600, 12QA1400600, XYQ2011017, 11411950501, 2013SY045, 2013SY054, 15ZR1406800, 20144Y0195 and 201305).
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Zhongshan Hospital of Fudan University, Shanghai, China.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that there is no conflict of interest related to this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yun-Shi Zhong, MD, PhD, Endoscopy Center, Zhongshan Hospital of Fudan University, No 180 Fenglin Road, Shanghai 200032, China. zhongamy2002@126.com
Telephone: +86-13564623481 Fax: +86-21-64041990
Received: August 1, 2015
Peer-review started: August 1, 2015
First decision: August 26, 2015
Revised: September 9, 2015
Accepted: October 17, 2015
Article in press: October 20, 2015
Published online: December 28, 2015
Processing time: 145 Days and 9 Hours
Abstract

AIM: To determine the feasibility and effectiveness of endoscopic resection for the treatment of colorectal granular cell tumors (GCTs).

METHODS: This was a retrospective study performed at a single institution. From January 2008 to April 2015, we examined a total of 11 lesions in 11 patients who were treated by an endoscopic procedure for colorectal GCTs in the Endoscopy Center, Zhongshan Hospital of Fudan University, Shanghai, China. Either endoscopic mucosal resection or endoscopic submucosal dissection (ESD) was performed by three surgeons with expertise in endoscopic treatment. The pre- and post-operative condition and follow-up of these patients were evaluated by colonoscopy and endoscopic ultrasonography (EUS).

RESULTS: Of these 11 lesions, 2 were located in the cecum, 3 were in the ileocecal junction, 5 were in the ascending colon, and 1 was in the rectum. The median maximum diameter of the tumors was 0.81 cm (range 0.4-1.2 cm). The en bloc rate was 100%, and the complete resection rate was 90.9% (10/11). Post-operative pathology in one patient showed a tumor at the cauterization margin. However, during ESD, this lesion was removed en bloc, and no tumor tissue was seen in the wound. No perforations or delayed perforations were observed and emergency surgery was not required for complications. All patients were followed up to May 2015, and none had recurrence, metastasis, or complaints of discomfort.

CONCLUSION: Endoscopic treatment performed by endoscopists with sufficient experience appears to be feasible and effective for colorectal GCTs.

Keywords: Endoscopic submucosal dissection; Granular cell tumors; Endoscopic mucosal resection; Colorectal

Core tip: Granular cell tumors (GCTs) are asymptomatic and are potentially malignant, which can pose a significant diagnostic and therapeutic challenge for endoscopists. The development of endoscopic techniques has had a marked influence on the diagnosis and treatment of colorectal submucosal tumors. We determined the feasibility and effectiveness of endoscopic resection for the treatment of colorectal GCTs. We conclude that endoscopic resection is safe and effective for treating colorectal GCTs, which allows en bloc resection in one visit, with a clear histological diagnosis, provides patients with a greater degree of comfort and leads to a better compliance.