Oral Granular Cell Tumors Clinical Presentation
- Author: Steven Brett Sloan, MD; Chief Editor: Dirk M Elston, MD more...
Granular cell tumors are slow-growing lesions (0.5-1 mm per year) that are neither painful nor tender. Congenital epulis apparently is neither painful nor tender. The rate of growth is difficult to determine because of its presence at birth and the need for its removal to allow feeding. No etiologic factors appear to be associated with either lesion. Note the image below.
Granular cell tumors usually are painless and appear as slightly yellowish swelling just beneath the surface epithelium. These lesions are firm and nontender on palpation and generally less than 2 cm in diameter. Ulceration of the surface epithelium is uncommon. Salivary gland obstruction by lesions on the floor of the mouth can cause pain. Displacement of the glossopharyngeal nerve and subsequent irritation from impingement against the styloid process can lead to pain with swallowing, turning the head, or extending the tongue (Eagle syndrome).
The head and neck region accounts for approximately 45-65% of all sites for granular cell tumors. Approximately 70% of oral granular cell tumors occur in the tongue.[6, 7] Buccal mucosa accounts for about 10-15% of oral lesions. Approximately 10% of lesions have been reported bilaterally. Multiple tumors are occasionally present.[8, 9, 10]
Congenital epulis occurs more frequently in the maxilla. These lesions generally are less than 2 cm in diameter. Large lesions can interfere with breathing and feeding.[11, 12]
The etiology of the granular cell tumor and congenital epulis is unknown.
Vered M, Carpenter WM, Buchner A. Granular cell tumor of the oral cavity: updated immunohistochemical profile. J Oral Pathol Med. 2009 Jan. 38(1):150-9. [Medline].
Ordóñez NG. Granular cell tumor: a review and update. Adv Anat Pathol. 1999 Jul. 6(4):186-203. [Medline].
Caltabiano R, Cappellani A, Di Vita M, Lanzafame S. The unique simultaneous occurrence of a squamous cell carcinoma and a granular cell tumor of the tongue at the same site: a histological and immunohistochemical study. J Craniofac Surg. 2008 Nov. 19(6):1691-4. [Medline].
Lahmam Bennani Z, Boussofara L, Saidi W, Bayou F, Ghariani N, Belajouza C, et al. [Childhood cutaneous Abrikossoff tumor]. Arch Pediatr. 2011 Jul. 18(7):778-82. [Medline].
Philipp K, Barnes EL, Carrau RL. Eagle syndrome produced by a granular cell tumor. Arch Otolaryngol Head Neck Surg. Dec 2001. 127(12):1499-1501. [Medline].
Becelli R, Perugini M, Gasparini G, Cassoni A, Fabiani F. Abrikossoff's tumor. J Craniofac Surg. 2001 Jan. 12(1):78-81. [Medline].
Nagaraj PB, Ongole R, Bhujanga-Rao BR. Granular cell tumor of the tongue in a 6-year-old girl--a case report. Med Oral Patol Oral Cir Bucal. Mar 2006. 11(2):E162-164. [Medline].
Curtis BV, Calcaterra TC, Coulson WF. Multiple granular cell tumor: a case report and review of the literature. Head Neck. 1997 Oct. 19(7):634-7. [Medline].
Taneeru S, Guttikonda VR, Yeluri S, Madala J. Granular cell ameloblastoma of jaw - Report of a case with an emphasis on its characterization. J Clin Exp Dent. 2013 Jul 1. 5(3):e154-6. [Medline]. [Full Text].
Lapid O, Shaco-Levy R, Krieger Y, Kachko L, Sagi A. Congenital epulis. Pediatrics. 2001 Feb. 107(2):E22. [Medline].
McGuire TP, Gomes PP, Freilich MM, Sándor GK. Congenital epulis: a surprise in the neonate. J Can Dent Assoc. 2006 Oct. 72(8):747-50. [Medline].
Vera-Sirera B, Vera-Sempere F. Adult rhabdomyoma with oncocytic changes affecting the floor of the mouth: optical, immunohistochemical, and ultrastructural study. J Craniofac Surg. 2012 Sep. 23(5):e412-5. [Medline].
Junquera LM, de Vicente JC, Vega JA, Losa JL, Albertos JM, López-Arranz JS. Granular-cell tumours: an immunohistochemical study. Br J Oral Maxillofac Surg. 1997 Jun. 35(3):180-4. [Medline].
Le BH, Boyer PJ, Lewis JE, Kapadia SB. Granular cell tumor: immunohistochemical assessment of inhibin-alpha, protein gene product 9.5, S100 protein, CD68, and Ki-67 proliferative index with clinical correlation. Arch Pathol Lab Med. 2004 Jul. 128(7):771-5. [Medline].
Stewart CM, Watson RE, Eversole LR, Fischlschweiger W, Leider AS. Oral granular cell tumors: a clinicopathologic and immunocytochemical study. Oral Surg Oral Med Oral Pathol. 1988 Apr. 65(4):427-35. [Medline].
Freitas VS, dos Santos JN, Oliveira MC, Santos PP, Freitas Rde A, de Souza LB. Intraoral granular cell tumors: clinicopathologic and immunohistochemical study. Quintessence Int. 2012 Feb. 43(2):135-42. [Medline].
Ruschel HC, Beilke LP, Beilke RP, Kramer PF. Congential epulis of newborn: report of a spontaneous regression case. J Clin Pediatr Dent. 2008. 33(2):167-9. [Medline].