Granular cell tumor of the hypopharynx treated by endoscopic CO2 laser excision: Report of two cases

Background. Granular cell tumor (GCT), or Abrikossoff's tumor, is an unusua l lesion probably arising from Schwann cells. It is frequently found in the head and neck region, where the tongue is the most commonly affected site. Involvement of the hypopharynx is exceedingly rare because, to the best of our knowledge, only four cases have been reported in the literature. Methods. We describe hypopharyngeal GCT in two women aged 29 and 52 years, respectively. Results. In the first patient, preoperative diagnostic examination, includi ng endoscopy, CT, and MRI scan, was suggestive of a benign lesion arising f rom the posterior wall of the hypopharynx. In the second patient, a previou s biopsy of the postcricoid area performed elsewhere suggested a diagnosis of well-differentiated squamous cell carcinoma, and CT scan staged the lesi on as T1 N0. In both cases, treatment included surgical excision under micr olaryngoscopy with CO2 laser. The histopathologic study of the specimens, s upported by immunohistochemical techniques, determined the lesions to be a GCT. The postoperative course was uneventful, and the patients were dischar ged 12 and 2 days after surgery, respectively. Both patients were asymptoma tic without evidence of recurrence when last seen 2 years and 4 months afte r surgery, respectively. Conclusions. GCT should be included in the differential diagnosis of submuc osal hypopharyngeal lesions. Endoscopy and radiologic imaging do not displa y any typical finding suggestive of the diagnosis, which can be based only on histologic findings. Resection of the tumor, when technically feasible, should be performed under microlaryngoscopy with the CO2 laser, which makes it possible to work in a bloodless field with minimal thermal damage and r eduction of scarring and postoperative edema. (C) 2000 John Wiley & Sons, I nc.