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Allergy and Airway |

Airway Obstruction Caused by Glomus Tumor

Amit Goyal, MD; Neeraj Desai, MD; Kevin Kovitz, MD; Sara Greenhill, MD
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Chicago Chest Center/Suburban Lung Associates, Elk Grove Village, IL


Chest. 2013;144(4_MeetingAbstracts):15A. doi:10.1378/chest.1705160
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Abstract

SESSION TITLE: Bronchology Case Report Posters I

SESSION TYPE: Affiliate Case Report Poster

PRESENTED ON: Tuesday, October 29, 2013 at 01:30 PM - 02:30 PM

INTRODUCTION: Glomus tumors are a rare disease entity, most commonly arising from the skin, subungal tissues, or the extremities. We present a case of airway obstruction caused by a glomus tumor relieved by rigid bronchoscopy and diode laser treatment.

CASE PRESENTATION: A 51 year old male with a twenty pack year history of tobacco abuse presented to the emergency room with intermittent chest pain and shortness of breath occurring over the prior month. Cardiac workup was unremarkable, and a chest CT demonstrated a left main stem bronchial lesion. Flexible bronchoscopy was performed and demonstrated an obstructing lesion in the proximal left mainstem, with a ball-valve effect with cough, causing it to obstruct the trachea. Endobronchial biopsies confirmed a glomus tumor. The patient subsequently underwent rigid bronchoscopy with mechanical debridement of the tumor and diode laser application to the stalk of the tumor along the posterior wall of the left mainstem bronchus. Followup flexible bronchoscopy four months later demonstrated no recurrence, and at twelve months, he remains disease free.

DISCUSSION: Glomus tumor was first described in 1924 by Masson, and the first tracheal tumor reported in 1950 by Hussarek1. Though often benign in nature, these tumors may cause clinically significant airway obstruction necessitating intervention. To date, less than thirty such cases have been identified in the literature, most commonly requiring surgical resection. In eight cases, endobronchial obstruction was relieved by rigid or flexible bronchoscopy with other ablative methods including Nd:Yag, APC, and electrocautery. This is the first case to our knowledge of successful tumor removal exclusively with rigid bronchoscopy and diode laser.

CONCLUSIONS: This case adds to the literature regarding this rare disease entity. Bronchoscopic therapy combined with available ablative techniques is becoming increasingly common and successful.

Reference #1: Colaut F. Tracheal Glomus Tumor Successfully Resected with Rigid Bronchoscopy. A Case Report. Journal of Thoracic Oncology. 2008;3:1065-1067.

DISCLOSURE: The following authors have nothing to disclose: Amit Goyal, Neeraj Desai, Kevin Kovitz, Sara Greenhill

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