Abrikossoff’s Tumour of OesophagusAn Innocent Bystander or a Silent Killer?

Abstract

Oesophageal Granular Cell Tumour (GCT) is a rare tumour arising from schwann cells of the submucosal nerve plexus. They are slow-growing generally, benign though malignant potential has been reported. They are usually found incidentally during endoscopic evaluation of dyspepsia or dysphagia. They rarely produce symptoms on their own unless the size is larger, ulceration occur on their surface or when it compresses the adjacent structure. Though they are submucosal, they are usually diagnosed by standard biopsy techniques or after an endoscopic resection. Oesophageal GCTs without muscularis propria attachment are amenable for Endoscopic Submucosal Dissection (ESD) which is a minimally invasive procedure when compared to surgical resection. They may require follow-up after resection. Here, we report a case of 39-year-old male who presented with epigastric pain, heart burn and underwent endoscopy for the same, which revealed a sub-centimetric yellowish white flat lesion above oesophago-gastric junction. Biopsy was done and histopathology and immuno-histochemistry revealed sheets of tumour cells with clear granular cytoplasm which stained positive for S100 and Calretinin, with a Ki-67 index of 2%, confirming the diagnosis of a benign GCT. Endoscopic Ultrasound (EUS) revealed no local invasion and the patient was advised three months follow-up and annual surveillance endoscopy.

Keywords

• biopsy
• granular cell tumour
• oesophago-gastric junction
• schwann cells