Pediatric Tracheobronchial Granular Cell Tumors: Case Series and Systematic Review

Background/Objectives: To report two cases of pediatric tracheobronchial granular cell tumor (GCT) and present a systematic review on the management and outcomes of pediatric tracheobronchial GCTs treated with endoscopic or open resection. Case Presentations: Case 1: A 10-year-old female presenting with severe obstructive sleep apnea was found to have a near-completely obstructing tracheal mass. Excisional biopsy revealed a GCT. She underwent definitive tracheal resection and re-anastomosis. There was no evidence of recurrence at 5 months postoperatively. Case 2: A 9-year-old female presenting with respiratory failure was found to have an endobronchial GCT. She underwent thoracotomy with right upper lobe resection and bronchoplasty, with no evidence of recurrence at 21 months postoperatively. Systematic Review Methods and Results: A medical librarian searched the published literature for records discussing “child OR pediatric” AND “granular cell tumor OR granular cell myoblastoma” AND “bronchial OR tracheal OR airway OR subglottis.” The primary outcome was recurrence following endoscopic or open resection. Of 152 records screened and an additional 3 records found from citation searching, 27 total articles met inclusion criteria. The majority of GCTs were managed with open resection (n = 19, 68%), while 9 were managed endoscopically. Tumor recurrence was reported in 4 patients who underwent endoscopic resection. Conclusions: GCT is rarely reported arising from the tracheobronchial tree. Both endoscopic and open approaches have been utilized for management, but recurrences have only been reported with endoscopic resection. We propose a clinical pathway for management and surveillance of pediatric tracheobronchial GCTs.