Introduction: Granular cell tumours are rare benign soft tissue tumour with neuroectodermal differentiation. They can be located in a wide variety of sites with 20% located in the head and neck with predilection for the tongue. To our knowledge this is the first published paediatric case of Nasopharyngeal granular cell tumour.
Clinical Case: 11 year old male referred to otolaryngology department with symptoms of persistent snoring, recurrent tonsillitis and nasal obstruction failed to manage with nasal sprays. Overnight oxygen saturation results were normal. Clinical examination showed bilateral grade 4 tonsils with turbinate erythema and hypertrophy. He had coblation adenotonsillectomy and examination under anaesthesia of the nose. The intraoperative findings showed grade 2 tonsils with large abnormal polypoid mass seen in the upper nasopharynx which was biopsied. The pathology results showed benign nasopharyngeal granular cell lesion. The patient was followed up after six weeks and he had ongoing nasal obstruction and snoring. He had nasoendoscopy in clinic which showed significant residual lesion occupying his nasopharynx. He had an MRI scan demonstrating benign residual nasopharyngeal tissue. Following discussion at skull base MDT he had completion removal of nasopharynx lesion with combined endonasal and transoral approach using coblation. Intraoperative findings demonstrated exophytic tumour arising from superior right nasopharynx overlying the right eustachian tube cushion. He is awaiting biopsy results and follow up in clinic.
Conclusion: This rare case of Nasopharyngeal granular cell lesion demonstrated the multidisciplinary approach to such lesions and the novel use of coblation technique in the excision of such lesions.