Granular cell tumor of the colon presenting as profound weight loss

Granular cell tumors (GCTs) are typically benign tumors of neuronal origin that stain positive for S-100. They traditionally occur in the skin and subcutaneous tissue with gastrointestinal tumor sites, such as the colon, being rare. On colonoscopy, they appear as a well-circumscribed, yellow, submucosal lesion. Biopsy prior to endoscopic or surgical removal can be inconclusive due to the submucosal nature of the lesion. Although GCTs are rarely malignant, they can metastasize with a high mortality rate. Endoscopic resection has been described as an appropriate treatment for tumors up to 5 cm in diameter. We present the case of a 19-year-old male who experienced a 60-pound weight loss, which was initially attributed to depression. On clinical examination, a GCT was found in his ascending colon.