Granular cell myoblastoma of the larynx

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Abstract
In the larynx there is a male preponderance of 2:1. The condition usually occurs in this site in the 3rd and 4th decades. The principal symptoms are cough and hoarseness. Occasionally, stridor and hemoptysis may be present. The occurrence of this tumor in symptom-free patients was also recorded. All areas of the larynx were involved but the commonest area is the vocal cord. It is usually a small circumscribed nonulcerated mass, sessile or pedunculated. Its color varies from pearly white, grey, purplish or yellow. These tumors are not encapsulated and show varying degrees of local infiltration. The posterior third of the vocal cord is the usual site of occurrence. The lesions were demonstrated by contrast laryngography and the nonspecific findings of a smooth sessile laryngeal mass and the absence of local spread suggest benign disease. Treatment for these lesions is thorough local excision and, with few exceptions, this can be accomplished endoscopically. Very few recurrences were reported. Two cases, both in children, required total laryngectomies for extensive involvement. A laryngofissure is occasionally indicated for access but radical treatment is rarely indicated. The most important feature of these tumors is that they may be mistaken histologically for a squamous cell carcinoma as over half of them develop an overlying pseudo epitheliomatous hyperplasia. Shallow biopsy specimens or tangential surface cuttings can look deceptively like a well-differentiated squamous cell carcinoma. All tissue removed must be carefully examined and tissue sections must be cut through the full depth of the tumor to avoid such an error. A case of granular cell myoblastoma of the larynx in an adolescent is described. This is an extremely rare condition and only 3 other cases in children were reported.

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