Granular cell tumor of the hypoglossal nerve presenting with tongue atrophy and deviation: a case report

Granular cell tumors (GCT) are rare tumors of Schwann cell origin which were more often found in subcutaneous locations than in relation to major nerves. We describe a GCT that occurred within the hypoglossal nerve located in the left submandibular area of a 32-year-old man who initially presented with a muscular atrophy and deviation of the tongue. We also review the literature related to the differential diagnoses of such a submandibular tumor, with particular emphasis on the origin of these possibilities. In this case, the lesion was observed within the hypoglossal nerve in the submandibular area. The hypoglossal nerve was transected above and below the mass in order to achieve an adequate resection. The pathology demonstrated polygonal cells with diffuse eosinophilic granular cytoplasm and positive for CD68 and S-100 which established the diagnosis of GCT. This is the first patient, to our knowledge, with a GCT arising from the hypoglossal nerve.