Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report

TL;DR

A rare case of a vocal cord tumor with subglottic extension was successfully treated with laser surgery, though a late complication required further intervention.

Contribution

This case report adds to the limited literature on laryngeal granular cell tumors with subglottic extension and their surgical management.

Findings

Laser excision was effective for removing a vocal cord granular cell tumor with subglottic extension.

A late granuloma formation occurred at the excision site, requiring revision surgery.

The patient remained symptom-free at 12 months post-treatment.

Abstract

Granular cell tumors (GCTs) are rare, benign tumors typically originating from Schwann cells, with the head and neck being the most common sites. Laryngeal GCTs, particularly those affecting the vocal cords, are exceedingly rare in adults. This report presents a 28-year-old female with a GCT of the left vocal cord extending into the subglottic region. The patient presented with progressive dysphonia, and laryngoscopy revealed a 2 cm × 1 cm mass on the left vocal cord. Microlaryngeal examination confirmed subglottic extension, and the tumor was excised using carbon dioxide (CO2) laser. Histopathological analysis confirmed GCT with S100 positivity. Two months later, the patient developed a late complication – granuloma formation at the excision site – necessitating revision surgery. The patient was symptom-free at the 12-month follow-up. GCTs in the vocal cords with subglottic extension are rare and challenging to diagnose and treat. They are generally benign lesions and rarely undergo malignant transformation. Diagnosis is confirmed through histology, and treatment involves wide local excision, with re-excision needed for recurrence. GCTs are chemo- and radio-insensitive, making surgery the primary treatment. This case underscores the importance of accurate diagnosis and tailored treatment, highlighting the need for further research on this rare condition.

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