A Case of Granular Cell Tumor of the Vocal Cord

Granular cell tumor (GCT) is a rare benign neoplasm that most commonly arises in the head and neck region. Laryngeal involvement is exceptional. A 45-year-old man presented with a 3-year history of progressive hoarseness without apparent precipitating factors. Occasional cough produced white, viscous sputum; neither dyspnea nor dysphagia was reported. Laryngoscopy revealed a smooth-surfaced, broad-based elevation involving the anterior two-thirds of the right true vocal fold. Histology revealed polygonal cells with abundant granular cytoplasm and a low nuclear-to-cytoplasmic ratio, set within a delicate fibrovascular stroma. Periodic acid-Schiff staining highlighted cytoplasmic granules. Immunohistochemistry demonstrated diffuse positivity for S-100, CD68, and neuron-specific enolase (NSE), confirming the diagnosis of GCT. The lesion was completely excised in two stages using low-temperature plasma radiofrequency ablation (LTP-RFA). At 24 months of follow-up, no evidence of recurrence was observed. GCT may be mistaken histologically for squamous cell carcinoma (SCC). Recognition of this differential diagnosis is essential for otolaryngologists.