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“Granular cell tumor (GCT) was first reported by Abrikossoff by the name of granular cell myoblastoma.1 These tumors are found mainly in skin, oral cavity and digestive tract. Most are benign lesions, but there are reports that malignancy may occur in 1–2%.2 The diagnosis is made by histopathology. GCT has eosinophilic cytoplasmatic granules and positivity for S-100 protein and neuron specific enolase. Although AZD5363 in vitro their cellular origin remained controversial for years, currently it is thought that GCT originates from Schwann cells.2 A 54-year-old

man presented with epigastric pain and was submitted to upper endoscopy. The endoscopy revealed a 10 mm subepithelial esophageal lesion above the esophagogastric junction. The lesion had a yellowish-white appearance, covered with normal mucosa, and was firm when prodded with the biopsy forceps. Although these characteristics are typical of CGT, it is not possible to make an accurate differential diagnosis from other subepithelial lesions such as lipomas by endoscopy.3 Biopsies (bite-on-bite) were performed and histopathological evaluation was suggestive of GCT. The lesion was characterized p38 MAPK cancer by ecoendoscopy as hypoechoid, heterogeneous and limited to the submucosa. Ultrasonography evaluation was important in the pre-treatment evaluation to confirm that the tumor was limited to the submucosa and presented minimal risk of perforation

during resection.4 The patient was being evaluated for an aortic aneurysm and a thoracoabdominal computed tomography was performed with no other lesions. 3-mercaptopyruvate sulfurtransferase Due to the most likely benign nature of the lesion, annual follow-up3 or endoscopic resection of the lesion were discussed with the patient, who agreed with the endoscopic approach. The lesion’s borders were marked with Argon-plasma coagulation (Fig. 1), and submucosal injection (10 ml) of sodium chloride 9% solution and adrenaline (1:100 000) elevated the lesion that was completely removed (Fig. 2) with a snare (Endocut® mode 2, ICC200, ERBE Elektromedizin GmbH, Germany). There were no procedure related complications. The histopathological evaluation confirmed the diagnosis (Fig. 3) and the surgical margin was tumor-free. The tumor site was reviewed six months later, with no lesion. There are no current guidelines for the treatment of GCT. Two different approaches are possible: endoscopic follow-up for lesions <10 mm or removal of larger lesions (>20 mm), specially when symptomatic or suspicious of malignancy.