Multiple granular cell tumor: a case report and review of the literature.

BACKGROUND: Granular cell tumor was first described by Abrikossoff in 1926. It is rare and usually presents as a benign solitary lesion. Multifocal and malignant forms are known to occur. METHODS: This presentation illustrates an additional case of granular cell tumor. Clinical and histological features to distinguish malignant and benign forms are presented. RESULTS: Tumor can develop years after therapy for the primary lesion. Treatment recommendations are presented. CONCLUSIONS: Patients diagnosed with granular cell tumor require close follow-up. Radiographic evaluation for the presence of metastatic disease is necessary if a malignant variant is suspected.

Intraoperative vascular endoscopy: early and late results.

In a prospective study, 60 consecutive cases of vascular endoscopy were analyzed to examine the role of angioscopy in infrainguinal vascular procedures. A total of 52 patients had 60 separate vascular endoscopy procedures performed as an adjunct to various vascular procedures; results of intraoperative arteriography were available in 38 of 60 cases. All patients were followed for at least 42 months. The 19 patients who underwent thrombectomy with angioscopy were compared with 19 age-matched control subjects who underwent infrainguinal thrombectomy without angioscopy to evaluate the influence of angioscopy on primary and secondary patency rates. Angioscopy allowed observation of 50 lesions; angiography failed to detect three. These findings altered surgical management in 24 cases (40%). Primary patency rates for the control and experimental thrombectomy groups were 38.8% and 6.5% at 42 months, respectively (p = 0.010 based on log-rank test). Secondary patency rates for the control and experimental groups at 42 months were 63.8% and 49%, respectively (p = 0.521). The limb salvage rate was 89% at 42 months for both groups (p = 0.973). Angioscopy provides the clinician with a direct view while he or she is performing vascular procedures. However, there was no statistical improvement in secondary patency and limb salvage rates. Furthermore, the use of angioscopy during thrombectomy may increase the propensity for subsequent intervention as evidenced by the frequency of changes in surgical management and the lower primary patency rate.