Glomus tumors are derived form specialized cells surrounding arteriovenous anastomosis. This is the 16th reported case involving the trachea and the first where three-dimensional reconstruction of computed tomography was used to clearly define extraluminal extension.
A 39 nine years old male had intermittent hemoptysis for two and a half years. His hemoptysis was attributed to gastroesophageal reflex. A screening computed tomography (CT) of the chest showed a tracheal mass. A bronchoscopy and biopsy of the mass showed it was a glomus tumor. The axial and reformatted images computed tomography (CT) of the chest with virtual bronchoscopic images were performed and clearly demonstrated extraluminal extension. A bronchoscopic-assisted sleeve resection with end to end anastomosis was carried out without complication and pathologic evaluation confirmed the extraluminal extension of tumor.DISCUSION: Glomus tumor originates in the modified smooth muscle cells of the glomus body. Four distinctive subtypes have been classified and these are classic glomus tumor, glomangioma, glomangiomyoma, and oncocytic glomus tumor. 1 Glomus tumor of the trachea is very rare with only 16 cases including our case have been described. 23. None of the tumors was locally invasive or had metastasis, however extratracheal extension was seen in four cases including our patient.CONCLUSIONS: Glomus tumor of the trachea is rare. Sleeve resection of the trachea and primary reconstruction is the treatment of choice.
Three dimensional reconstruction CT is helpful to evaluate extraluminal extension of a tracheal glomus tumor prior to surgery.
H.F. Nadrous, None.