Multiple synchronous granular cell tumors involving the colon, appendix and mesentery: a case report and review of the literature.

A granular cell tumor (GCT) is typically a benign neural tumor of Schwann cell origin that occurs in the 4th to 6th decade of life usually as a solitary painless nodule in the dermis or subcutis. It can also be found in internal organs including the larynx, bronchus and gastrointestinal (GI) tract. Within the GI tract, it is most common in the esophagus followed by colon. Colonic GCT is mostly found incidentally during colonoscopy or surgical resection as a solitary submucosal sessile nodule, although, some may cause rectal bleeding. In this report, we describe a case of a 62 year-old woman who was found to have submucosal rectosigmoid mass at screening sigmoidoscopy. Full colonoscopy and CT-scan studies revealed multiple GCTs of the colon, appendix and the mesentery, raising the suspicion of malignant metastatic disease. However, surgical resection of all the masses in an exploratory laporatomy proved them to be benign GCTs. This case emphasizes the need to consider GCTs of the GI tract when multiple asymptomatic lesions are found incidentally in the colon before any aggressive surgical intervention is undertaken. It is also the first case of GCT involving the mesentery. A literature review of GCT of the GI tract is also provided.