Tracheal Glomus Tumor: A Case Report and Review of the Literature

Abstract

Glomus tumors are rare neoplasms that typically occur within the dermis or subcutis of the subungual space. Primary glomus tumors of the thorax are exceedingly uncommon, thus standard-of-care management is lacking. In this report we describe the management of a patient presenting with a symptomatic glomus tumor of the posterior trachea, and provide a comprehensive review including all documented tracheal glomus tumor reports.

Tracheal glomus tumor: An aggressive rare neoplasm

“…Complete tumor resection with a negative margin is the standard of care for malignant tracheal GT because of high locoregional failure and distant metastasis in a patient with incomplete tumor resection. [ 4 ] Metastasis is the main cause of death in GT. Furthermore, data for adjuvant treatment are limited in literature.…”

Synaptophysin Positive Glomus Tumor of Trachea Simulating Typical Carcinoid: A Potential trap

“…Glomus tumors account for < 2% of all soft tissue tumors, typically seen within the dermis or subcutis of distal extremities, particularly the subungual space, hand, wrist and foot [1][2][3]. They very rarely occur in deep soft tissue and visceral organs, where glomus bodies are absent, and unlike cutaneous GT they are painless [3,6].…”

“…Histomorphologically, GTs show nests of uniform round cells around branching vascular channels, similar to a carcinoid [1,2]; however, carcinoid can be distinguished by diffuse immunoexpression of CK and neuroendocrine markers (synaptophysin and chromogranin). Thus, an aberrant synaptophysin expression in GT can prompt an erroneous diagnosis of carcinoid.…”

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

“…bronchoscopic resection of the tumor using laser photocoagulation, electrocautery, or mechanical debulking) may be designated if (1) the alteration is rigorously restricted to the airway lumen without distension into the tracheal wall, (2) the tumor is histologically benign, (3) as a first-line action in critical conditions where instantaneous restoration of airway is compulsory allowing patient stabilization before surgery or (4) the patient is unfit or unwilling for surgery [2]. With the experience of at least 82 cases published until 2019 and an inconsistent yet increasing trend to resect these lesions endoscopically: exclusive bronchoscopic interventional techniques with or without adjuvant radiotherapy should be reserved for either high-risk patients or patients with inoperable tumors [11]. All other patients should not be withheld from the multidisciplinary aspects of the sequential treatment process.…”