Endoscopic Submucosal Tunnel Dissection for Esophageal Granular Cell Tumor Resection

Publication date: January 2014 Source:Video Journal and Encyclopedia of GI Endoscopy, Volume 1, Issues 3–4 Author(s): Francisco Baldaque-Silva , Margarida Marques , Joanne Lopes , Guilherme Macedo Endoscopic submucosal tunnel dissection (ESTD) was recently described for the resection of upper gastrointestinal submucosal tumors, namely leiomyomas, GISTs and aberrant pancreas. Granular cell tumors (GCT) are usually benign, but should be removed when symptomatic, significantly increase in size or have atypical histological or ultrasonographic features. We aim to describe the role of ESTD for the resection of an esophageal GCT. A 51 year-old patient was referred to us due to the presence of an esophageal submucosal lesion with increased size in the follow-up. Deep biopsy specimens were positive for granular cell tumor. Suboptimal submucosal lifting precluded conventional endoscopic submucosal dissection (ESD). In this context an ESTD was performed. First, a submucosal tunnel was created starting 5cm above the tumor. Afterwards, the GCT was carefully dissected from the overlying submucosa and muscularis propria using TT knife and IT knife2. The ESTD procedure was possible and en bloc resection achieved, being the 25mm long lesion retrieved. The mucosal orifices were closed using conventional clips. The patient started oral diet 1 day after ESTD and was discharged at day 4 without any complications. In this first report of ESTD for esophageal GCT resection, this technique...
Source: Video Journal and Encyclopedia of GI Endoscopy - Category: Gastroenterology Source Type: research