Granular cell tumors of the larynx – two case reports

Granular cell tumors are a rare tumor entity in the head and neck. The most common tumor location is the oral cavity, particularly the tongue. Only 10% of head and neck manifestations affect the larynx. The predilection site on the larynx is the posterior part of the vocal folds. The tumor can occur at any age and regardless of gender.

A 48-year-old male patient presented with progressive hoarseness. He also had a history of smoking with 30 pack years. An endoscopy revealed a vocal fold polyp on the left vocal process and a leukoplakia on the right arytenoid. Both findings were removed. The histopathological work-up revealed an inconspicuous vocal fold polyp and a granular cell tumor on the right arytenoid, requiring a secondary surgical laser resection at this site.

In another case, a 25-year-old female patient presented with hoarseness and partial aphonia. Noxious agents were denied. The clinical examination revealed a lesion on the posterior third of the right vocal fold. After initial biopsy, the tumor was resected by laser surgery in a second step. Histopathologically, a granular cell tumor was confirmed.

Due to the unspecific clinical appearance, the diagnosis can only be decided by immunohistochemistry. Granular cell tumors are histologically characterized by the presence of S100, CD57, CD68 and SOX10 positive polygonal fine granular cells. After complete resection, recurrence rates of 2-3% are described, with no known case of developing metastases.

 

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Artikel online veröffentlicht:
19. April 2024