Complicated pediatric subglottic granular cell tumor with extensive intraluminal and extraluminal invasion

Subglottic granular cell tumors (GCT) are rare, potentially life threatening benign tumors. Complete resection is necessary, yet care must be taken to preserve laryngeal function. We present the first description of a pediatric subglottic GCT with extensive invasion beyond the confines of the subglottis to include the vocal folds and central neck. Urgent endoscopic debulking avoided tracheotomy and facilitated extubation. Later, complete resection required hemithyroidectomy, laryngofissure and partial cricotracheal resection. We conclude that endoscopic debulking is an appropriate initial treatment. Transmural extension should be suspected in tumors larger than 1cm and warn of the need for tracheal resection.