We present a rare case of a facial nerve granular cell tumour in the right parotid gland, in a 10-year-old boy. A parotid or neurogenic tumour was suspected, based on magnetic resonance imaging. Intra-operatively, strong adhesions to surrounding structures were found, and a midfacial nerve branch had to be sacrificed for complete tumour removal. Recent reports verify that granular cell tumours arise from Schwann cells of peripheral nerve branches. The rarity of this tumour within the parotid gland, its origin from peripheral nerves, its sometimes misleading imaging characteristics, and its rare presentation with facial weakness and pain all have considerable implications on the surgical strategy and pre-operative counselling. Fine needle aspiration cytology may confirm the neurogenic origin of this lesion. When resecting the tumour, the surgeon must anticipate strong adherence to the facial nerve and be prepared to graft, or sacrifice, certain branches of this nerve.

Granular cell tumours of the larynx are a very rare cause of persistent hoarse or husky voice in children. We report the case of a 13-year-old girl who presented with a three-year history of progressively huskier voice. We discuss the presentation, location and diagnosis of the tumour. In addition, we present a method of surgical treatment of the tumour, involving the hitherto unreported technique of laser excision and frozen section of the lesion.

An extremely rare case of a granular cell tumour arising from the right Kiesselbach's area (Little's area) of the nasal septum is reported. A 69-year-old Japanese woman consulted our clinic and her chief complaints were of continuous serous discharge, stuffiness and occasional slight bleeding from the right nasal cavity. Fibrescopy showed a multilocular mass, which was provisionally considered a nasal polyp. Surgical excision was attempted. During surgery, the tumour shrank markedly following local application of adrenaline, suggestive of hypervascularity. The tumour was successfully excised by careful dissection after cauterisation of the mucosa surrounding the tumour. Histopathological examination revealed morphological features of granular cell tumour immunopositive for S-100 protein. This is the first report of granular cell tumour arising from the Kiesselbach's area in the English literature. The eccentric behaviour of the tumour and the management of a granular cell tumour arising from this area are discussed, together with a literature review.

A granular cell tumour is a rare lesion of probable nerve sheath origin. It is typically benign but up to seven per cent may be malignant. Since its original description in the tongue in 1926, the tumour has been reported to occur at many other sites in the body. The authors report a case of a 49-year-old African woman with an oronaso-parapharyngeal granular cell neoplasm causing mild dysphagia. The location of this tumour, which has not been reported previously, posed a unique surgical challenge. An initial attempt to remove the lesion transorally was only partially successful because it was too tough and adherent for conventional surgical dissecting instruments. Complete resection, however, was achieved with a carbon dioxide laser via the same approach. This information may be helpful in the management of other similar cases in the future.

Granular cell tumour is a rare neoplasm that can occur in various sites. This report describes a 48-year-old female with a malignant granular cell tumour originating from the cervical sympathetic nerve trunk, who presented with hyperaesthesia of the left shoulder. The tumour had a maximum diameter of 86 mm and involved adjacent tissues directly.

Histopathologically, it showed considerable variation in the size and shape of nuclei, with occasional mitosis and an abundant granular cytoplasm. Immunohistochemically, the tumour reacted positively for S-100 protein and neuron-specific enolase, indicating its neural origin. Following total local excision of the lesion, the patient has been well without recurrence.

Granular cell tumour (GCT) of the larynx is an uncommon laryngeal tumour. It is always benign and commonly located in the posterior part of the larynx. Care must be taken to differentiate this lesion from others due to the presence of pseudo-epitheliomatous hyperplasia which overlies the GCT and may occasionally mimic squamous cell carcinoma. Therefore, histological differentiation is important because these tumours are normally managed conservatively. The origin of this tumour is a matter of debate, but most authors believe it to be neural in origin. The rarity of this tumour in the male population prompted reporting this case in the literature.

Granular cell tumour is a rare benign neoplasm, that can affect many parts of the body, as single or multiple lesions. It is more common in black people and females. Typically it occurs between the fourth and fifth decades of life, with the median age for the laryngeal variety as 36 years. About 30 to 50 per cent occur in the tongue and 30 per cent in the skin.

A case of granular cell tumour of the larynx is reported in an eight-year-old girl, presenting with hoarseness of voice. She was successfully treated with local excision of the tumour. This tumour is rare in the larynx where it is more common in males than females although granular cell tumours are found more frequently in females generally.

For these reasons the authors suspect that their case, of a laryngeal granular cell tumour occurring in an eight-year-old girl might be the youngest to be reported.