- Case report
- Open Access
- Open Peer Review
This article has Open Peer Review reports available.
Spontaneous bleeding of an Abrikossoff's tumor - a case report
© Honigmann et al; licensee BioMed Central Ltd. 2009
Received: 9 June 2009
Accepted: 28 October 2009
Published: 28 October 2009
Abrikossoff tumors are a rare tumor entity. The complication of a hemothorax has not been described in the literature so far. A 24-year-old patient presented with repeated hemoptysis and right thoracic pain. The initial CT-scan revealed a solid tumor mass in the right lower bronchus. After further diagnostics, the patient was discharged and surgical intervention was planned. He was readmitted 4 days after discharge with a spontaneous hemothorax. After the right lower lobectomy and an uneventful course the patient recovered well.
Our 24-year-old non-smoking male patient presented with repeated hemoptysis in May 2008 with 4 days of concomitant right thoracic pain which intensified while breathing. During holidays in his home country, this Cuban patient suffered from a cold with fever and a strong cough. The strong dry cough persisted after recovery from the cold. The patient did not report any loss of weight.
About 130 cases of pulmonary occurrence of Abrikossoff's tumor have been described in the literature up until now. Van der Maten et al.  reported an incidence of this mostly benign and slow-growing tumor in the tracheobronchial system in the Netherlands of 2:100,000. In this retrospective case series, the upper tracheobronchial system was more frequently affected than the lower part, and 65% of the patients were smokers. Valenstein  reported a more frequent occurrence on the right than on the left side, and most commonly with a cough as the presenting symptom. This kind of tumor can occur anywhere in the body, but mainly in the head and neck region, mostly intraoral [4–7]. Other localizations are the skin, thoracic region, breast and GI-tract [8, 9]. Only 10% are located in the pulmonary system and of these, 25% are multiple occurrences. Deavers  presented a slight trend for a predilection of dark-skinned patients. He also reported on the infiltrative nature of this tumor and described a peribronchial tissue extension of 48% which often makes it impossible to excise the tumor bronchoscopically. Daniel et al.  reported that tumors with a diameter of 8 mm or greater are likely to invade the full-thickness bronchial wall, with infiltration into the peribronchial tissue. They recommend a lobectomy or pneumonectomy for the treatment of bronchial tumors with extensive destruction of distal tissue. If there is no extensive distal suppuration or tissue destruction the tumors can be excised bronchoscopically as long as they are less than 8 mm in diameter. Bronchoscopical treatment of larger tumors is associated with a significant increase in the recurrence rate. In addition, the hemorrhage rate is also increased [12, 13].
Our patient recovered fully from the surgical intervention and presented in very good condition during follow-up.
Vascular arrosions of this tumor entity have not been described in the literature so far. The occurrence of a hemothorax is a rare complication but one which has to be kept in mind by the treating surgeon.
Written informed consent was obtained from the patient for this publication including any accompanying images. A copy of the signed consent is available for review by the Editor-in-Chief of this journal.
- Abrikosov AA: Über Myome ausgehend von der quergestreiften willkürlichen Muskulatur. Virchows Arch. 1926, 260: 215-33. 10.1007/BF02078314.View ArticleGoogle Scholar
- Maten van der J, Blaauwgeers JL, Sutedja TG, Kwa HB, Postmus PE, Wagenaar SS: Granular cell tumors of the tracheobronchial tree. J Thorac Cardiovasc Surg. 2003, 126 (3): 740-3. 10.1016/S0022-5223(03)00601-9.View ArticlePubMedGoogle Scholar
- Valenstein SL, Thurer RJ: Granular cell myoblastoma of the bronchus. Case report and literature review. J Thorac Cardiovasc Surg. 1978, 76 (4): 465-8.PubMedGoogle Scholar
- Buley ID, Garter KC, Kelly PMA, Heryet A, Millard PR: Granular cell turnouts revisited. An immunhistochemical and ultrastructural study. Histopathology. 1988, 12: 263-274. 10.1111/j.1365-2559.1988.tb01941.x.View ArticlePubMedGoogle Scholar
- Enzinger FM, Weiss SW: Soft tissue tumors. St. Louis-Baltimore-Berlin-Boston-Carlsbad-Chicago-London-Madrid-Naples-NewYork-Philadelphia-Sydney-Tokyo-Toronto, Mosby-Year Book. 1995, 864-875.Google Scholar
- Lack EE, Worsham GF, Callihan MD, Crawford BE, Klappenbach S, Rowden G, Chun B: Granular Cell Tumor: A Clinicopathologic Study of 110 Patients. J Surg Oncol. 1980, 13: 301-316. 10.1002/jso.2930130405.View ArticlePubMedGoogle Scholar
- Peterson LJ: Granular cell tumor. Review of the literature and report of a case. Oral Surg. 1974, 37: 728-735. 10.1016/0030-4220(74)90138-8.View ArticlePubMedGoogle Scholar
- Koch M, Hanke S, Dittert J, Stoelben E: Die thorakoskopische Excision eines unklaren intrumuralen Oesophagustumors (Granularzell-tumor/Abrikossof Tumor). Chirurg. 1998, 69: 981-984. 10.1007/s001040050526.View ArticlePubMedGoogle Scholar
- Orlowska J, Pachlewski J, Gugulski A, Butruk E: A conservative approach to granular cell tumors of the esophagus: four case reports and literature review. Aln J Gastrnenterol. 1993, 88: 311-315.Google Scholar
- Deavers M, Guinee D, Koss MN, Travis WD: Granular cell tumors of the lung. Clinicopathologic study of 20 cases. Am J Surg Pathol. 1995, 19 (6): 627-35. 10.1097/00000478-199506000-00002.View ArticlePubMedGoogle Scholar
- Daniel TM, Smith RH, Faunce HF, Sylvest VM: Transbronchoscopic versus surgical resection of tracheobronchial granular cell myoblastomas. Suggested approach based on follow-up of all treated cases. J Thorac Cardiovasc Surg. 1980, 80 (6): 898-903.PubMedGoogle Scholar
- Ramsey JH: Bronchial granular cell myoblastomas. Arch Otolaryngol. 1955, 62: 81-83.View ArticleGoogle Scholar
- Kommel RM, Bernstein J: Granular cell myoblastoma of the bronchus. Report of a case. Harper Hosp Bull. 1960, 18: 20-24.Google Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.