Extensive granular cell tumour of the larynx and trachea (a case report)

Case Report: Defect repair post-resection of cervical tracheal granular cell tumor by cervical anterior banded myofascial flap: A case study and literature review

Objective

A case of cervical tracheal granular cell tumor (CTGCT) is reported together with a discussion on the clinical manifestation, diagnosis, and treatment of CTGCT. Additional cases of tumors in the tracheal membrane are also discussed. A simple and viable tracheal reconstruction method was proposed. The research design involves a case report and literature review.

Methods

Twenty-four case reports on cervical GCT with complete clinical data were identified, with a specific focus on cases involving surgical treatment of tumors in the cervical tracheal membrane.

Results

Twenty-eight reports of GCT in the cervical trachea and six reports on cervical tracheal membrane tumors were identified. The clinical data of a middle-aged Asian woman with a cervical GCT was also discussed.

Conclusion

Cervical GCT is a rare disease, and tracheal resection is a reasonable treatment for cervical tracheal GCT. The proposed procedure is a simple and feasible method for reconstruction of the cervical tracheal membrane defect using a double-pedicled banded myofascial flap.

Laryngeal granular cell tumors in children: A literature review

OBJECTIVE

Granular cell tumors of the larynx are exceedingly rare in the pediatric population. The purpose of this review is to further characterize features of these tumors and trends in their management.

METHODS

A search of the PubMed, Ovid Medline and Cochrane Collaboration databases was undertaken using the terms: pediatric, child, laryngeal, larynx, granular cell tumor, granular cell myoblastoma, benign mass.

RESULTS

A total of 38 children with laryngeal granular cell tumor were identified. Their ages ranged from 4 to 16 years. The most common presenting symptom was dysphonia. Five patients were previously treated for asthma. Within the laryngeal subsites, 49% presented with subglottic tumors, while 43% were found at the level of the glottis. Subglottic tumors were found anteriorly 42% of the time and posteriorly 53% of the time. Multifocal disease was present in four patients. Around half of patients were treated by cold steel excision and/or CO₂ laser, 31% through laryngofissure, and two required laryngectomy. There were four documented cases of recurrence ranging from 4 months to 3 years after treatment.

CONCLUSIONS

Laryngeal granular cell tumor during childhood occurs most commonly in the subglottis. Posterior laryngeal tumors were more frequent than anterior tumors. Patients should be carefully evaluated for multifocal disease. Long-term surveillance for recurrence is recommended.

Management of pediatric airway granular cell tumor: role of laryngotracheal reconstruction

OBJECTIVE

To discuss the role of laryngotracheal reconstruction (LTR) in granular cell tumor (GCT) and to highlight the importance and seriousness of GCT in pediatric airway cases.

METHODS

A historical literature review was performed and a GCT case from the University of Miami Pediatric Otolaryngology Clinic is presented to highlight the role of LTR in the treatment of GCT.

RESULTS

A case of a GCT of the laryngotracheal airway is reported and the management is discussed. Histological discussion and a review of the literature are included regarding GCT. This case is the third reported in the English literature of two synchronous GCT lesions of the upper airway repaired with a laryngotracheal reconstruction.

CONCLUSIONS

In the authors' experience once conservative management consisting of endoscopic debulking has failed the treatment of choice for GCTs of the pediatric airway that are unresectable is a single stage laryngotracheal reconstruction with negative frozen section pathology to assure total wide local excision.

Granular cell tumor of the trachea in pregnancy: a case report and review of literature

OBJECTIVES/HYPOTHESIS

The objectives were to present a case report of a woman with recurrent disease during consecutive pregnancies and to discuss the diagnosis and management of granular cell tracheal tumors, with particular attention to pregnancy and hyperestrogenic states.

STUDY DESIGN

Case report and literature review.

METHODS

A Medline search and comprehensive review of literature to assess all cases of granular cell tumors of the trachea were compared and collected, with particular attention to individual cases of pregnancy or cases related to the hyperestrogenic state.

RESULTS

Thirty-two cases of granular cell tumors of the trachea were found. Only a few cases related to the hyperestrogenic state were obtained. The case report describes a woman with recurrent disease in subsequent pregnancies during the later stages of pregnancy.

CONCLUSION

Few cases of granular cell tumors of the trachea have been reported, with even fewer being pregnancy related. The diagnosis and management of these tumors include careful attention to patient symptoms and airway management.

Granular cell tumors of the larynx

Granular cell tumor is a rare neoplasm that may involve the larynx. It is almost always benign. Laryngologists should be familiar with this unusual tumor, its implications and appropriate treatment.

Tracheal neoplasms in children

Primary tracheal neoplasms are extremely rare lesions in the pediatric age group. This study reviews the English-language literature to better characterize these lesions in children and reports 2 additional patients. Reports of only 36 infants and children through adolescence with primary tracheal neoplasms were discovered after an exhaustive literature review of the last 30 years. The data are analyzed with regard to pathology, demographics, symptomatology, site, and percent luminal obstruction. We report 2 additional patients with photographic documentation, imaging studies, and histopathology. Of the 36 previously reported lesions, 64% were characterized as benign and 36% as malignant. Fifty-six percent of all lesions were initially misdiagnosed as asthma. The most common site was the posterior membranous wall of the cervical trachea. In 14 (39%) of the 36 patients, the lesions obstructed more than 50% of the lumen at the time of diagnosis. The timely diagnosis of tracheal masses depends upon maintaining a high index of suspicion and conducting an efficient workup, including definitive evaluation by bronchoscopy. The evaluation and the differential diagnosis of tracheal neoplasms in the pediatric population is discussed.

Granular Cell Tumor of the Larynx in a Six-Year-Old Child: Case Report and Review of the Literature

Granular cell tumors (granular cell myoblastomas) are uncommon neoplasms in the adult population, occurring predominantly in the head and neck and most frequently in the tongue. Laryngeal presentations are unusual, and granular cell tumors of the larynx in children are extremely rare, with a total of 19 cases reported in the literature in children under the age of] 7 years. We report an additional case of a laryngeal granular cell tumor, in a six-year-old boy, and discuss the clinical, histologic, ultrastructural and therapeutic aspects of these neoplasms.

Granular cell tumour in a child's trachea--a diagnostic and therapeutic challenge

Granular cell tumours (GCT) are uncommon benign neoplasms of neurogenic origin, only rarely occurring in the trachea. This report describes a 12-year-old boy suffering from progressing dyspnea. A GCT, located both intra- and extraluminally in the lower cervical trachea, was diagnosed by CT scan and endoscopy. The airway was secured primarily by a low tracheotomy after institution of a femorofemoral bypass in the face of inadequate oxygenation and secondarily by tracheal resection and end-to-end anastomosis.

Granular cell tumors of the head and neck in children: the experience at the Children's Hospital of Philadelphia

Granular cell tumors are rare, usually benign tumors of controversial histogenesis. These tumors are uncommon in children. Granular cell tumors in adults have a predilection for the head and neck, but this was not noted in our experience with children. Of the 22 granular cell tumors diagnosed and managed at the Children's Hospital of Philadelphia from 1960 to 1988, 7 were from the head and neck. One child with a subglottic granular cell tumor is of particular interest and is presented in detail.