Glomus tumors of the trachea: 2 case reports and a review of the literature

Abstract

Glomus tumors (GTs) of the trachea are very rare neoplasms that usually arise from the distal portion of the respiratory tree. The origin of these tumors is modified smooth muscle cells of glomus bodies. In this study, we describe two cases of GT of the trachea, as well as the histologic features of these tumors and their treatments. One tumor was diagnosed via bronchoscopic biopsy, and the other tumor was diagnosed via surgery. Clinical follow-up showed that the two patients are alive and well after 8 and 15 months post-treatment, respectively. We also review the literature regarding GTs and discuss the clinical presentation, histologic features, differential diagnosis, treatment and prognosis of these tumors.

Glomus tumor of the trachea – Synopsis of histology & methodology of treatment

“…From history to the facts of the 21st century: Glomus tumors are mesenchymal neoplasms that encompass up to 2% of soft tissue tumors [4]. They originate from altered smooth muscle cells surrounding the thermo-regulating arteriovenous anastomoses in the glomus bodies, which are typically existent within the profound dermis and adjacent subcutaneous tissue, particularly in the subungual regions of the digits, arms, and feet.…”

“…A myopericytoma contains spindle-shaped cells with elongated nuclei, the vessels show a “staghorn-like” arrangement, and the cells tint positive for vimentin (±CD34 and CD56). Smooth-muscle differentiation is infrequent [4]. Amending further differential diagnoses of endobronchial pathologies, these are (1) ulterior airway tumors (squamous cell carcinoma, adenoid cystic carcinoma, squamous cell papilloma, mucoepidermoid carcinoma, hamartoma, lipoma, epithelioid leiomyoma, chondromas, endobronchial plasmocytoma, paraganglioma, hemangioendotheliomas, and tracheal amyloidosis), (2) infections (mucus plugs, tuberculosis), and (3) inflammatory diseases (sarcoidosis, Wegener disease, rheumatoid granuloma) [9].…”

Central Airway Obstruction Due to Tracheal Glomus Tumor

“…There have been approximately 70 case reports to date, and interestingly half of these reports have occurred in the past decade. 2 It is unclear if there has been an increase in incidence or if there has been improved pathologic identification. They occur most commonly in the 4th and 5th decades of life with 2:1 male predominance, 2 and they have the potential to be malignant.…”

“… 2 It is unclear if there has been an increase in incidence or if there has been improved pathologic identification. They occur most commonly in the 4th and 5th decades of life with 2:1 male predominance, 2 and they have the potential to be malignant. 3 While almost half are located in the distal trachea, they can be found throughout the trachea.…”

“… 1 They most commonly occur in the subungual space and dermis; however, they can occur throughout the body including bone, stomach, lung, mediastinum, and trachea. 1 2 From these possible sites, tracheal glomus tumors are the most clinically significant as they can cause malignant, central airway obstruction. We report the presentation of a patient with hemoptysis requiring urgent intervention to secure the airway and the subsequent surgical management.…”