J Pathol Transl Med.  2020 Jul;54(4):336-339. 10.4132/jptm.2020.02.28.

Pediatric granular cell tumor in the posterior wall of the larynx extending to the trachea

Affiliations
  • 1Department of Pathology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
  • 2Department of Pediatrics, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea

Abstract

Granular cell tumor (GCT) is a slow-growing benign neoplasm that can be found in any organ. Pediatric laryngotracheal GCT is rare. We experienced a 6-year-old boy suffering from a barking cough and symptoms of stridor and croup for one month. Head and neck computed tomography revealed a protruding mass that occluded 60% of the airway lumen. Under the impression of hemangioma or papilloma, excision revealed a submucosal non-encapsulated mass. Histologically, the mass was composed of sheets of large polyhedralshaped tumor cells containing plump eosinophilic granular cytoplasm and centrally placed, small, bland-appearing nuclei. The tumor cells were positive for S-100 protein, and voluminous eosinophilic cytoplasm was stained by diastase-resistant periodic acid-Schiff. The present report describes a unique case of a huge pediatric laryngeal GCT extending to the subglottic trachea. We also review the clinical course of pediatric laryngotracheal GCT and emphasize the importance of diagnosing GCT in children.

Keyword

Granular cell tumor; Trachea; Larynx; Children

Figure

  • Fig. 1. (A) Laryngoscopy shows scattered swelling and a crust-like lump lesion, causing subglottic stenosis and stricture. (B) Head and neck computed tomography reveals a 2.2-cm-sized lesion (arrow) with heterogeneous enhancement in the posterior wall of the subglottic trachea.

  • Fig. 2. (A) Large polygonal-shaped tumor cells fill the subepithelial stroma. Note the overlying pseudoepitheliomatous hyperplastic squamous epithelium. The inset indicates tumor cells containing fine granular cytoplasm. (B) Voluminous cells are strongly stained with periodic acid–Schiff with diastase-pretreatment (left) and S-100 protein (right).


Reference

1. Dunaway CL, Brogdon BG, Robinson AE. Granular cell myoblastoma of the trachea. Pediatr Radiol. 1981; 11:210–1.
Article
2. Burton DM, Heffner DK, Patow CA. Granular cell tumors of the trachea. Laryngoscope. 1992; 102:807–13.
Article
3. Holland RS, Abaza N, Balsara G, Lesser R. Granular cell tumor of the larynx in a six-year-old child: case report and review of the literature. Ear Nose Throat J. 1998; 77:652–60.
Article
4. Amar YG, Nguyen LH, Manoukian JJ, Nguyen VH, O'Gorman A, Shapiro R. Granular cell tumor of the trachea in a child. Int J Pediatr Otorhinolaryngol. 2002; 62:75–80.
Article
5. Spandow O, Lindholm CE. Granular cell tumour in a child’s trachea: a diagnostic and therapeutic challenge. Int J Pediatr Otorhinolaryngol. 1994; 30:159–66.
6. Fanburg-Smith JC, Meis-Kindblom JM, Fante R, Kindblom LG. Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol. 1998; 22:779–94.
7. Schrader KA, Nelson TN, De Luca A, Huntsman DG, McGillivray BC. Multiple granular cell tumors are an associated feature of LEOPARD syndrome caused by mutation in PTPN11. Clin Genet. 2009; 75:185–9.
8. White JB, Glade R, Rossi CT, Bielamowicz S. Granular cell tumors of the larynx: diagnosis and management. J Voice. 2009; 23:516–7.
Article
9. Pernas FG, Younis RT, Lehman DA, Robinson PG. Management of pediatric airway granular cell tumor: role of laryngotracheal reconstruction. Int J Pediatr Otorhinolaryngol. 2006; 70:957–63.
Article
10. Daniel TM, Smith RH, Faunce HF, Sylvest VM. Transbronchoscopic versus surgical resection of tracheobronchial granular cell myoblastomas. Suggested approach based on follow-up of all treated cases. J Thorac Cardiovasc Surg. 1980; 80:898–903.
Full Text Links
  • JPTM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr