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Vol. 99. Issue 2.
Pages 147-151 (February 2021)
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Vol. 99. Issue 2.
Pages 147-151 (February 2021)
Innovation in surgical technique
DOI: 10.1016/j.cireng.2021.01.004
Cervical esophaguectomy plus tracheal resection and free jeyuno graft as treatment of esophageal granular cell tumor
Esofaguectomía cervical más resección traqueal e injerto de yeyuno libre como tratamiento de un tumor de células granulares esofágico
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Mónica Miróa,
Corresponding author
mmiro@bellvitgehospital.cat

Corresponding author.
, Francisco Rivasb, Ana Lópezc, Leandre Farrana
a Unidad de Cirugía Esofagogástrica, Servicio de Cirugía General y Digestiva, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
b Servicio de Cirugía Torácica, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
c Servicio de Cirugía Plástica y Reconstructiva, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
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Abstract

Granular cell tumor is a very rare entity (0.03%) with controversial management, due to its low incidence and its usually benign behavior (98%). Its location in the digestive tract is unusual (3–11%), being the esophagus the most frequently affected organ, with about 400 published cases. However, the incidence in the cervical esophagus is anecdotal (20 published cases).

We present a patient with an esophageal granular cell tumor that invaded trachea, thyroid and soft tissues, performing a block resection of the cervical esophagus, two tracheal rings, thyroid and prethyroid musculature. For digestive reconstruction, a free jejunum graft with microvascular anastomosis was made and tracheal reconstruction was performed using term-terminal anastomosis.

The importance of the case is twofold: to contribute more casuistry, and to describe a highly complex surgical technique never indicated in this type of tumors, due to its rarely aggressive character.

Keywords:
Granular cell tumor
Esophagectomy
Free jejunum graft
Tracheal resection
Resumen

El tumor de células granulares es una entidad muy infrecuente (0,03%) y con un manejo terapéutico controvertido debido a su escasa incidencia y a su comportamiento habitualmente benigno (98%). Su localización en el tracto digestivo es inusual (3–11%), y el esófago es el órgano más frecuentemente afectado, con unos 400 casos publicados. Sin embargo, la incidencia en el esófago cervical es anecdótica (20 casos publicados).

Presentamos un paciente con un tumor de células granulares esofágico que invadía tráquea, tiroides y partes blandas, realizándose una resección en bloque de esófago cervical, dos anillos traqueales, tiroides y musculatura pretiroidea. Para la reconstrucción digestiva se empleó un injerto de yeyuno libre con anastomosis microvascular y reconstrucción traqueal mediante anastomosis termino-terminal.

La importancia del caso es doble: aportar mayor casuística y describir una técnica quirúrgica altamente compleja nunca indicada en este tipo de tumores debido a su carácter raramente agresivo.

Palabras clave:
Tumor de células granulares
Esofaguectomía
Injerto de yeyuno libre
Resección traqueal

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