Granular Cell Tumor of the Deep Lobe of the Parotid Gland Presenting With Respiratory Obstruction: Clinicopathologic Report of a Rare Presentation

Abstract

Background Granular cell tumor (GCT) is a very rare, slow-growing, benign neoplasm with a controversial etiology, recently believed to be derived from Schwann cells. Hardly grows large and is also infrequently seen in children. Seventy percent of this tumor is seen in the head and neck with 1/3 in other parts of the body. Seldom occurs in the parotid gland and more so, the deep lobe of the parotid, where it may initially be asymptomatic but when large, it may result in respiratory obstruction. Case report : An 8-year-old female presented with a large right lateral upper neck-facial swelling of 3 months duration with a change in voice, difficulty swallowing, and respiratory distress. We reported an uncommon case of GCT of the deep lobe of parotid in a child with respiratory distress due to tumor obstruction of the airway. Tumor excision with preservation of the facial nerve was successfully performed. The histopathological report confirms the diagnosis of GCT. The child recovered to full general health with no signs of recurrence. Conclusion Granular cell tumor is a rare neoplasm, treatment is local surgical excision. Recurrence is uncommon, even if the lesion is not entirely removed. Microscopically this tumor may mimic a malignancy because of pseudoepitheliomatous hyperplasia of the overlying epithelium. The pathologist should be aware of this possibility to avoid a mistaken diagnosis of cancer.