Glomus Tumor of the Trachea: Value of Multidetector Computed Tomographic Virtual Bronchoscopy

doi:10.4065/79.2.237

Mayo Clinic Proceedings

Volume 79, Issue 2, February 2004, Pages 237-240

https://doi.org/10.4065/79.2.237 Get rights and content

Glomus tumor of the trachea is extremely rare. We report a case of tracheal glomus tumor in a 39-year-old man who presented with hemoptysis. The diagnosis was made after bronchoscopic biopsy of a tumor involving the posterior wall of the upper trachea. Thin-section multidetector computed tomography of the chest was performed before surgical resection, with multiplanar re-formations and 3-dimensional virtual bronchoscopic reconstruction. Tracheal sleeve resection with reconstruction was successful, and pathological studies confirmed complete resection and the diagnosis of glomus tumor. The patient was disease-free 3 months postoperatively. To our knowledge, this is the first reported case in which additional computed postprocessing was used to help evaluate the extent of such a tumor.

Section snippets

REPORT OF A CASE

A 39-year-old man was referred to our institution for evaluation of a glomus tumor of the trachea. He had had hemoptysis intermittently for 2½ years before diagnosis of the tracheal tumor. Initially, the hemoptysis was attributed to gastroesophageal reflux with esophageal erosions. The patient underwent esophageal dilation and was treated with a proton pump inhibitor. Seven months before referral, screening CT of the chest showed a tracheal mass. Bronchoscopy revealed a 1.4-cm polypoid tumor

DISCUSSION

Tracheal tumors are rare, and most are malignant.⁴ Endoscopic examination is the most reliable means of establishing the diagnosis and should be performed in patients suspected of having such tumors to confirm the diagnosis and guide management.⁴

First described by Masson⁵ in 1924, glomus tumors consist of cells that resemble the modified smooth muscle of the normal glomus body.¹ According to the new World Health Organization classification of tumors,⁶ they can be divided into 3 broad groups on

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Cited by (23)

Glomus tumour of the cervical trachea, report of a case and review of the literature
2021, Otolaryngology Case Reports
To describe the diagnostic and surgical management of a cervical tracheal glomus tumour and to perform a contemporary systematic review.
We describe the management of a patient with cervical tracheal glomus tumour. Subsequently, a literature search in the PubMed/MEDLINE database for the last 20 years, from January 2000 to June 2020 was performed. The primary objective studies were those with patients who have been diagnosed and treated for glomus tumour of the trachea. Using this framework, two reviewers retrieved studies and those were critically evaluated.
A total of 68 reports were screened for eligibility and 33 were included based on inclusion-exclusion criteria with 36 patients included. The most common location was the thoracic segment (82.9%) being cough and dyspnoea the most prevalent presenting symptoms. No risk factors for tracheal glomus tumour were identified. Diagnostic techniques included cross sectional imaging and bronchoscopy. Surgical excision is the preferred treatment option. With a median follow up of 20.7 months, all patients were alive and free of recurrence.
Tracheal glomus tumour is extremely rare, especially those located in the cervical segment of the trachea. Due to the silent evolution of the disease and the difficulty of exploration, this tumour is normally diagnosed with severe tracheal obstruction. Although this is a benign process in the majority of cases, the best treatment option is surgical excision, or endoscopic resection in selected cases.
The tumour reported in this article was in close relation with the thyroid gland and the recurrent laryngeal nerve, creating a new surgical challenge for the head and neck surgeon.
Tracheal glomus tumor successfully resected with rigid bronchoscopy: A case report
2008, Journal of Thoracic Oncology
Citation Excerpt :
Unusual sites of origin have included the stomach, mediastinum, vagina, penis, lung and trachea.2,3 Glomus tumors of the trachea are distinctly rare; to our knowledge only 17 cases, including this one, have been reported in world-literature so far.2,4 In the cases reported in literature (Table 1) all tumors arise from the posterior wall of the trachea and most are in the lower two thirds of the trachea.
A patient with chest pain and hemoptysis
2007, Respiratory Medicine Extra
Glomus tumours are distinctive neoplasms arising in the cells of the glomus body. Histologically they resemble modified smooth muscle cells. It usually occurs over the limbs. However, several unusual sites of occurrence have been described. These include the patella, chest wall, bone, heart, stomach, eyelid, lung, rectum, etc. Tracheal tumours have been described.
We discuss a case of glomus tumour arising from the proximal trachea in a 43-year old male with complaints of intermittent hemoptysis and chest pain, and describe resection of this tumour using a rigid bronchoscopic technique.
An overview of tracheal glomus tumours is presented.
Tracheal glomus tumor
2006, Journal of Thoracic and Cardiovascular Surgery
Pleomorphic adenoma of the trachea. Case report
2006, Revista Portuguesa de Pneumologia
Os autores apresentam o caso de um doente com um adenoma pleomórfico da traqueia, diagnosticado no contexto da avaliação clínica de doença pulmonar obstrutiva crónica ou neoplasia broncopulmonar, tendo em conta a dimensão dos seus hábitos tabágicos e a história familiar positiva para patologia oncológica.
O doente foi submetido a ressecção segmentar da traqueia com excisão total do tumor, antevendo-se bom prognóstico.
Rev Port Pneumol 2006; XII (2): 177-183
The authors present a case of a pleomorphic adenoma of the trachea, diagnosed during the clinical evaluation of a suspected COPD or lung cancer in a heavy smoker patient with a positive family history of oncologic diseases.
The patient underwent segmental resection of the trachea with complete excision of the tumour, and a good prognosis is anticipated.
Rev Port Pneumol 2006; XII (2): 177-183
Tracheal myxoma: A rare benign tracheal tumor
2004, Mayo Clinic Proceedings
Citation Excerpt :
It also helps to locate the position of the tumor and the amount of the trachea that will need to be resected for complete excision. Moreover, patency of airways distal to an obstruction can be assessed better than with fiberoptic bronchoscopy.10,11 Fiberoptic bronchoscopy remains the gold standard to confirm a specific pathologic diagnosis.5,12
Benign tracheal tumors are rare. We describe a 39-year-old man who underwent resection of a tracheal myxoma, a previously unrecognized benign tracheal neoplasm. He presented with a 9-month history of wheezing, cough, and dyspnea on exertion. Treatment with bronchodilators and corticosteroids administered by inhalation and systemically did not diminish his symptoms. Pulmonary function tests showed a pattern of airflow limitation consistent with variable extrathoracic obstruction. Chest radiography and computed tomography revealed a tracheal mass. Tracheal resection of the tumor with reconstruction was curative. The patient is free of disease 7 years after surgery.

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: We thank Lisa R. Gilbertson for secretarial assistance.

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Case ReportGlomus Tumor of the Trachea: Value of Multidetector Computed Tomographic Virtual Bronchoscopy

Section snippets

REPORT OF A CASE

DISCUSSION

Ann Thorac Surg

Chest

Ann Thorac Surg

Ann Thorac Surg

Perivascular tumors

Atypical and malignant glomus tumors: analysis of 52 cases, with a proposal for the reclassification of glomus tumors

Am J Surg Pathol

Tracheal tumors

Chest Surg Clin N Am

Le glomus neuromyoarterial des regions táctiles et ses tumeurs

Lyon Chir

Glomus tumours