Pancreatic Duct Obstruction in a Middle-Aged Woman: A Case Report.

Background: Granular cell tumors (GCTs) are rare benign neoplasms of Schwann cells. These tumors have been described in almost every human organ. Although GCT has been described in the pancreas previously, we present a case report about GCTs in multiple organs at a simultaneous time. Case Presentation: A 51-year-old Caucasian female known with epilepsy and COPD presented with recurrent abdominal pain. Previously, endoscopic mucosal resection in the esophagus and lumpectomy of the right breast were performed for what proved to be GCTs. Computed tomography showed a hypodense unclearly demarcated tumor of the pancreas tail-body with the impression of infiltrative growth and pancreatic duct dilation. The patient underwent an uncomplicated distal pancreatectomy with the pathological examination showing a fibrotic area of 6 mm consisting of diffusely spread nests of large cells embedded in a collagenous stroma of the pancreatic tail. The tumor nuclei were not atypical and the cytoplasm was granular and eosinophilic. The cell clusters stained positive for S-100 and CD68 in the cell cytoplasm. The diagnosis, GCT of the pancreas, was made and the postoperative course was uneventful for our patient, and a year after surgery, there have been no new tumorous lesions detected. Conclusion: We present a rare case of multiple GCTs affecting the breast, esophagus, and pancreas. Although GCT of the pancreas is a rare disease, the diagnosis should be considered if there is GCT in the medical history of the patient.