Granular cell tumour of the oesophagus: a rare cause of dysphagia with differential diagnosis of oesophageal neoplastic lesions

Granular cell tumour is a relatively uncommon, typically benign neoplasm of soft tissue. The macroscopic appearance of oesophageal granular cell tumou r is a polypoid lesion, which is often asymptomatic and can be found incide ntally, but, in some cases, is symptomatic and requires a correct different ial diagnosis with malignant neoplasms of the oesophagus. We describe the c ase of a 28-year-old female who came to our attention due to a six-month hi story of heartburn and dysphagia. Oesophagogastroduodenoscopy showed the pr esence of a polypoid lesion 2 cm above the gastro-oesophageal junction. The overlying mucosa was normal and the lesion seemed to be an isolated submuc osal nodule with a "submucosal pill" appearance. It was excised completely using a standard diathermic snare, and diagnosis of oesophageal granular ce ll tumour was made by histological and immunohistochemical staining. The pa tient's symptoms disappeared immediately after removal of the nodule by end oscopic polypectomy, and no macroscopic or microscopic recurrence of granul ar cell tumour was noted during follow-up. Likewise, the patient was sympto m-free during follow-up. This case shows that endoscopy is very effective, not only in the diagnosis, but also in the treatment of oesophageal lesions which require careful differential diagnosis.