Atypical granular cell tumor of the larynx: an unusually aggressive tumor clinically and microscopically.

A 36-year-old man presented with a recurrent, rapidly enlarging laryngeal tumor causing upper airway obstruction. Microscopic study revealed a granular cell tumor (GCT) with marked atypia, pleomorphism, and pagetoid spread to the overlying epithelium. Histologic pleomorphism occurs rarely and is usually mild in laryngeal GCT. Malignant granular cell tumor (MGCT), a very unusual entity, can be diagnosed with confidence when there is clinical evidence of malignancy (i.e., metastasis). We support the concept of "atypical" GCT when marked pleomorphism is present, yet no metastasis has occurred. This will indicate to the otolaryngologist and pathologist the possibility of greater potential for aggressive clinical behavior.

Complications following rhinotomy. Review of 148 patients.

For the period 1974 to 1988, 148 patients undergoing 162 rhinotomies at The Mount Sinai Medical Center, New York, for a variety of benign and malignant neoplasms were reviewed with particular attention to postoperative complications. The effects of certain predisposing factors such as prior rhinotomy, lateral versus total rhinotomy, additional medial maxillectomy or craniofacial resection, and preoperative irradiation or nasal bone erosion are discussed. In addition, a surgical technique of rhinotomy with medial maxillectomy is presented that includes maneuvers designed to prevent these complications.