Granular cell tumor (GCT) is a benign tumor that can arise in any organ. Laryngeal GCT is rare. In most cases of laryngeal GCT, the tumor is reported to arise from a vocal cord. Epiglottic GCT is extremely rare, with only 1 case reported in the literature until date.
An asymptomatic 52-year-old male patient was referred to our hospital after he was detected as having an epiglottic lesion during a routine upper gastrointestinal endoscopy. A white mass measuring about 1 cm in diameter was found on the epiglottis. We performed trans oral surgery using a flexible-tip rigid endoscope under general anesthesia. Histological examination of biopsy specimens revealed the diagnosis of well-differentiated SCC. Therefore, we immediately performed total resection of the tumor, including the epiglottic cartilage. Histopathological examination of the resected specimen revealed large cells with granular eosinophilic cytoplasm, which showed positive immunohistochemical staining for s-100 protein. Thus, the diagnosis of GCT with pseudoepithelial hyperplasia was confirmed by histopathology.
Presence of pseudoepithelial hyperplasia is common in cases of GCT, which could cause it to be mistaken for well-differentiated SCC, especially in small biopsy specimens. Treatment of GCT is surgical resection with a clear margin. End-flexible-rigidscopic transoral surgery (E-TOS) for epiglottic GCT may be useful as a minimally invasive surgery. GCT is usually a benign neoplasm, although malignant transformation has been reported in 1%–2% of patients. Our patient showed no sign of recurrence until the last follow-up at 3 years after surgery. However, further regular follow-up is necessary.
