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Granular Cell Tumor of the Larynx

last modified on: Thu, 12/28/2023 - 14:39

return to: Laryngeal Surgery (Benign Disease) Protocols

see also: Granular Cell Tumor of Larynx: Case Example (1)

Background

  • Granular cell tumor is a rare soft tissue neoplasm of uncertain cell type origin. Electron microscopy and immunohistochemistry studies support the theory that it is likely derived from Schwann cells. Characterized by granular cytoplasm due to accumulation of secondary lysosomes, hence granular cell tumor, although this is a non-specific histological feature. (Parker, 2010) (Osipov, 2016)
  • Granular cell tumor can develop in any part of the body with 50% in the head and neck region. Laryngeal granular cell tumor forms 3% to 10% of all cases. (Strong, 1970) (Berkowitz, 1985) (Lazar, 1992)
  • Less than 2% of granular cell tumors are malignant with poor prognosis. (Osipov, 2016)

Presentation

  • The patient can present with persistent hoarseness, stridor, hemoptysis, dysphagia, and otalgia, or it can be asymptomatic. (Parker, 2010)
  • Grossly, laryngeal granular cell tumors typically appear small (<2cm), rounded, firm submucous tumors covered with whitish gray or yellow, flat and normal, mucosa and they often resemble vocal fold polyps or granulomas. (Parker, 2010)
  • These tumors mostly involve the posterior third of the true vocal cords but are also found on the anterior commissure, arytenoids, the false vocal folds, subglottis, and the postcricoid region. (Parker, 2010)
  • Granular cell tumors tend to be solid and homogenously enhancing on CT scans, often mimicking a squamous cell carcinoma. (Mukherji, 1995) (Parker, 2010)

Surgical treatment

References

Park J-H, Do N-Y, Cho S-I, Choi J-Y. Granular Cell Tumor on Larynx. Clinical and Experimental Otorhinolaryngology. 2010;3(1):52-55. doi:10.3342/ceo.2010.3.1.52.

Osipov OV, Shidham VB, Rao N, Pandit AW. Granular cells tumor. Medscape Web site. http://emedicine.medscape.com/article/282430-overview. Updated 2016. Accessed 10/9, 2016.

Strong EW, McDivitt RW, Brasfield RD. Granular cell myoblastoma. Cancer. 1970;25(2):415-422.

Berkowitz SF, Hirsh BC, Vonderheid E. Granular cell tumor: A great masquerader. Cutis. 1985;35(4):355-356.

Lazar RH, Younis RT, Kluka EA, Joyner RE, Storgion S. Granular cell tumor of the larynx: Report of two pediatric cases. Ear Nose Throat J. 1992;71(9):440-443.

Mukherji SK, Castillo M, Rao V, Weissler M. Granular cell tumors of the subglottic region of the larynx: CT and MR findings. AJR Am J Roentgenol. 1995;164(6):1492-1494.

Luke AS, Mairson TM, Husain IA, Kaplan SE. Granular Cell Tumors of the Larynx: A Systematic Review. Laryngoscope. 2023 Oct 2. doi: 10.1002/lary.31071. Epub ahead of print. PMID: 37782552.