Granular Cell Tumors of the Larynx: A Clinicopathologic Study of Five Patients

Granular Cell Tumors of the Larynx: A Systematic Review

OBJECTIVE

Granular cell tumor of the larynx is an uncommon, typically benign lesion that may be confused for a malignant neoplasm based on histopathology. This review examines cases of granular cell tumor of the larynx in adults to highlight key distinctions in diagnosis/management and demonstrate how misclassification may lead to unnecessary escalations in therapy.

DATA SOURCES AND METHODS

A systematic search of PubMed, Ovid, and EBSCO Search Hosts was completed in December 2021. The search yielded 501 articles with 87 full-text articles included in the review. Primary search terms included granular cell, tumor, larynx, and adult. Primary endpoints were patient presentation, primary management, pathological features, and disease course.

RESULTS

A systematic review of 87 articles identified 200 patients with granular cell tumors (GCTs) of the larynx. Of the 200 patients, 50.3% were males and 49.7% were females. Of these, 54.0% were reported as white patients, and 46.0% were reported as black patients. The most common presenting symptoms were dysphonia (85.9%) and stridor/dyspnea (14.1%). On examination, the lesions were most commonly polypoid/nodular and firm. Pseudoepitheliomatous hyperplasia (PEH) was identified in 33.5% of cases, and 2% of cases were malignant. GCTs were misdiagnosed as other malignant lesions in 11% of cases. In benign cases, 13.5% of patients underwent additional surgeries beyond simple excision/laryngofissure, including laryngectomy and neck dissection. Less than 2% of lesions reoccurred.

CONCLUSION

Granular cell tumors of the larynx are typically benign lesions that may be misdiagnosed with unnecessary escalation of treatment. However, most lesions resolve via primary surgical excision. Laryngoscope, 134:1523-1530, 2024.

Granular cell tumor of the vocal cord: Case Report and Literature Review

Introduction and importance

Granular cell tumors (GCT) are rare neoplasms. The most common places are the head and neck. The larynx accounts for 3‐10% of cases.

Presentation of case

We present the case of a man who consulted our Department of Otorhinolaryngology due to long-term progressive dysphonia without dyspnea or dysphagia. Fibrolaryngoscopy revealed a tumor that affected the left vocal cord. The tumor was surgically resected. The histopathological report revealed a laryngeal GCT. Fourteen months after surgery, the patient had no recurrence.

Clinical discussion

Patients with GCT of the larynx typically have persistent hoarseness, stridor, dysphagia and otalgia, but can also be asymptomatic. A definitive diagnosis is provided by histopathology with immunohistochemistry, and the treatment of choice is surgical resection. Unlike the literature, our report concerns a young man.

Conclusion

Granular cell tumor is a rare tumor of the larynx and should be considered a differential diagnosis in all adult men with long-standing dysphonia.

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Granular cell tumor is an uncommon tumor of the larynx and should be considered as differential diagnosis in laryngeal masses.

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The main presenting symptom is dysphonia and is important that all otorhinolaryngologists are familiar with this entity.

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A definitive diagnosis is based on histopathology and immunohistochemistry.

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Treatment is surgical and consists of complete resection of the lesion.

Rare Case of Pediatric Upper Airway Obstruction: Laryngeal Granular Cell Tumor

Granular cell tumors (GCTs) are uncommon neoplasms of unknown origin that can manifest in multiple locations throughout the body. Physicians should be aware of this type of tumor presenting in unusual locations such as the larynx, particularly in pediatric patients with stridor and dysphonia. We describe an 11-year-old female with a large laryngeal mass that obstructed the majority of the laryngeal lumen. A tracheotomy was performed to secure the patient's airway, followed by a direct suspension laryngoscopy, during which the mass was excised in its entirety. The biopsied mass was histopathologically and immunohistochemically examined to confirm the diagnosis of granular cell tumor. She benefited from treatment and experienced a favorable outcome. This case report emphasizes the critical nature of properly diagnosing this type of tumor in patients who present with vocal or respiratory symptoms.

Rare Diseases of Larynx, Trachea and Thyroid

This review article covers data on rare diseases of the larynx, the trachea and the thyroid. In particular, congenital malformations, rare manifestations of inflammatory laryngeal disorders, benign and malignant epithelial as well as non-epithelial tumors, laryngeal and tracheal manifestations of general diseases and, finally, thyroid disorders are discussed. The individual chapters contain an overview of the data situation in the literature, the clinical appearance of each disorder, important key points for diagnosis and therapy and a statement on the prognosis of the disease. Finally, the authors indicate on study registers and self-help groups.