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Abstract

Granular cell tumor (GCT) is uncommon soft tissue neoplasm occurring in the skin and internal organs. Its clinical behavior is usually benign, although both histological and clinical malignant forms can occur. We report a 52 years man,  singer, with very hard,  sessile, verrucous  tumor in distal o e s o p h a g u s , discovered endoscopically. It  appeared ( looked ) as a yellow hemispheric  protrusion with a thin mucous membrane known as “sweet corn”.  Patient was presented  with  dysphagia, gastralgia and substernal pain, 6 years ago. Wide local  excision of the verrucous lesion  has been done endoscopically. Histologically, oesophagus  showed  the overlying pseudoepitheliomatous hyperplasia, so extensive that it has been mimick a squamous carcinoma. However, on the base of histologically, histochemically (PAS positive  ) and immunohistochemicaly (S-100 positive  granular cytoplasm ) examinations,  GCT diagnosis has been confirmed. ( revealed ).

In the s k i n,  solitary, brownnish dome-shaped  nodus has been discovered  on periumbilical skin,  surounded  by generalized  lentiginosis without any symptom ( „ beauty mark“ by patient, s opinion), existing during last 15 years.

The excised lesions did not  recur, but newer  lesions continued to discover, during the last four years:  in stomach, duodenum and   caecoascendens. On colonoscopy, induced by both abdominal colic,  the   large ( to 3 cm.) and numerous ( 26 ) submucous, nodular,  yellowish masses with hyalinization and calcification were found in cecoascendens.  GCT diagnosis  of colon, on small endoscopical  biopsies was   pointed out,  followed  by right colectomy with good clinical course after 24-month follow-up. Eight months after the surgery, patient experienced hematemesis and melena. Gastroduodenoscopy was performed, revealing numerous white, solid and confluent nodules, up to 1cm in diameter in stomach, while the only one ulcerous change was found in duodenum.  Immunohistochemical ABC method, by using S-100 marker, also  confirmed GCT. Therapy :  right  colectomy, 23 cm. of length,  has been done. The patient is with a good health ,  24 months  after right colectomy