Neck and superior mediastinal granular cell tumor excised via a combined approach

Granular cell tumor (GCT) is an uncommon tumor of Schwann cell origin. GCT occurs in various sites throughout the body, but mediastinal GCT is very rare. We present an extremely rare case of GCT of the neck and superior mediastinum. A 36-year-old man with a 3-month history of cough was investigated at our hospital. CT and MRI revealed a spindle-shaped mass in the left neck and superior mediastinum, with features suggesting a neurogenic tumor. The tumor was successfully excised via combined neck incision and video-assisted thoracoscopic surgery. Histopathological examination showed proliferation of polygonal and spindled cells with eosinophilic granule-rich cytoplasm. These cells were S-100 protein positive, and the cytoplasmic granules were periodic acid-Schiff positive. Based on these histopathological and immunohistochemical findings, a diagnosis of GCT was established. The patient developed hoarseness immediately after the operation, and laryngoscopy revealed the left vocal cord palsy in the paramedian position, which resolved after about 3 months. The tumor did not recur during the following 10 months.