Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Endosc. Jan 16, 2012; 4(1): 17-21
Published online Jan 16, 2012. doi: 10.4253/wjge.v4.i1.17
Endoscopic submucosal dissection for esophageal granular cell tumor using the clutch cutter
Keishi Komori, Kazuya Akahoshi, Yoshimasa Tanaka, Yasuaki Motomura, Masaru Kubokawa, Soichi Itaba, Terumasa Hisano, Takashi Osoegawa, Naotaka Nakama, Risa Iwao, Masafumi Oya, Kazuhiko Nakamura
Keishi Komori, Kazuya Akahoshi, Yoshimasa Tanaka, Yasuaki Motomura, Masaru Kubokawa, Soichi Itaba, Terumasa Hisano, Takashi Osoegawa, Naotaka Nakama, Risa Iwao, Department of Gastroenterology, Aso Iizuka Hospital, 3-83, Yoshio-machi, Iizuka, Fukuoka 820-8505, Japan
Masafumi Oya, Departments of Pathology, Aso Iizuka Hospital, 3-83, Yoshio-machi, Iizuka, Fukuoka 820-8505, Japan
Kazuhiko Nakamura, Department ofMedicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
Author contributions: Komori K and Akahoshi K wrote the paper. Akahoshi K developed the Clutch Cutter; Akahoshi K, Tanaka Y, MotomuraY, Kubokawa M, Itaba S, HisanoT, OsoegawaT, Nakama N, Iwao R and Nakamura K contributed analytic tools, Oya M performed histological analysis.
Correspondence to: Kazuya Akahoshi, MD, PhD, Department of Gastroenterology, Aso Iizuka Hospital, 3-83, Yoshio-machiizuka 820-8505, Japan. kakahoshi2@aol.com
Telephone: +81-948-223800 Fax: +81-948-298747
Received: April 19, 2011
Revised: September 1, 2011
Accepted: January 12, 2012
Published online: January 16, 2012
Abstract

Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate. The shortcomings of this method are the deficiencies of fixing the knife to the target lesion, and of compressing it. These shortcomings can lead to major complications such as perforation and bleeding. To reduce the risk of complications related to ESD, we developed a new grasping type scissors forceps (Clutch Cutter®, Fujifilm, Japan) which can grasp and incise the targeted tissue using an electrosurgical current. Esophagogastroduodenoscopy on a 59-year-old Japanese man revealed a 16mm esophageal submucosal nodule with central depression. Endoscopic ultrasonography demonstrated a hypoechoic solid tumor limited to the submucosa without lymph node involvement. The histologic diagnosis of the specimen obtained by biopsy was granular cell tumor. It was safely and accurately resected without unexpected incision by ESD using the CC. No delayed hemorrhage or perforation occurred. Histological examination confirmed that the granular cell tumor was completely excised with negative resection margin.We report herein a case of esophageal granular cell tumor successfully treated by an ESD technique using the CC.

Keywords: Endoscopic submucosal dissection, Esophageal granular cell tumor, Clutch Cutter, Endoscopic therapy, Grasping type scissors forceps