A 33-year-old woman presented with abdominal pain of two months duration located in the right iliac fossa without other accompanying symptoms.
The patient came to several hospitals where she was discharged with normal basic complementary tests.
He came to our hospital emergency department with persistent symptoms.
Abdominal Doppler-ultrasound was performed, in which a nodule of one centimeter of hypervascularized diameter was observed in the right iliac fossa.
The patient was admitted to our service with the presumptive diagnosis of endometrioma to complete studies.
Computed tomography performed during admission showed a single 1 x 1.5 cm nodule located in the appendix.
The patient underwent exploratory laparoscopy which identified the appendix without inflammatory signs, with the nodule previously described.
Anatomopathological examination of the extracted specimen shows macroscopically a hard consistency nodule at the tip of the appendix that is reported as granular cell tumor.
The lesion extends through the subserous adipose tissue of the appendix.
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Histologically, the proliferative cell is medium to large size with a wide cytoplasm and small nuclei with patent nucleolus highlighting the presence of eosinophils granules in the cytoplasm.
Immunohistochemistry shows positivity for S100 protein.
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Once the histological diagnosis is known, upper and lower endoscopies are performed, which do not detect other lesions.
