Glomus tumor of the trachea: value of multidetector computed tomographic virtual bronchoscopy

Glomus Tumors: A Systematic Review of the Sub-Saharan Africa Experience

Background

Glomus tumors are rare benign tumors that were first described in 1812 by Wood. They arise from normal glomus apparatus, usually located in the reticular dermis of the body. Although glomus tumors are universal in occurrence, the sub-Saharan Africa experience has not been well documented.

Methods

The authors performed a systematic literature review of eligible studies between 1960 and August 2023, using the terms "glomus," "tumor," "glomangioma," "glomangiomyoma," and "Africa." We also performed a search of the AIC Kijabe Hospital pathology department database of about 140,000 records, covering 30 years, for the terms "glomus tumor," "glomangioma" and "glomangiomyoma."

Results

The systematic literature search and institutional database search produced a total of 74 patients who had glomus tumors. These patients had a lag of between 3 months and 20 years from symptom development to definitive treatment.

Conclusions

There are very few reports of glomus tumors from sub-Saharan Africa in the current literature: the authors' histopathology database of 140,000 specimens had 46 glomus tumors (0.03%), and only 28 additional patients were found in literature from sub-Saharan Africa. The low numbers of African patients may indicate racial differences in the occurrence of glomus tumors, although this may also be due to failure of clinicians to recognize glomus tumors. The prolonged lag period between symptom development and definitive treatment for glomus tumors indicates the need for diligence in the diagnosis and treatment of a simple problem that is otherwise the cause of incapacitating pain and misery.

The mimic of tracheal carcinoid in elderly female

We present a case of a glomus tumor of trachea in an elderly female who presented with a mass originating from the posterior trachea. She underwent rigid bronchoscopy with tumor debulking combined with laser therapy. Frozen section initially suggested carcinoid tumor but later turned out to be a glomus tumor. She improved with additional laser therapy. We present her clinical course and a literature review on glomus tumor.

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

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.

Glomangioma of the trachea: A case report and literature review

A 44-year-old male presented with progressing cough, dyspnea and hemoptysis due to a tracheal tumor involving the posterior wall of the lower trachea, with severe airway obstruction and coagulopathy. Consequently the patient underwent segmental resection of the trachea with an end-to-end anastomosis. Twenty months after treatment there remained no evidence of endobronchial recurrence at bronchoscopy or imaging studies. The diagnosis was benign tracheal glomus tumor (GT) which is an exceedingly rare mass lesion in the trachea. There are three subtypes: GT proper, glomangioma and glomangiomyoma. The present study describes the clinical and pathological features of glomangioma through a case report and literature review. To the best of our knowledge, this is the fifth report of glomangioma subtype arising from the trachea.

Glomus tumor of the trachea managed by spiral tracheoplasty

Patient: Female, 58

Final Diagnosis: Glomus tutor of trachea

Symptoms: Hemopthysis

Medication: —

Clinical Procedure: —

Specialty: Otolaryngology

Central Airway Obstruction Masquerading as Difficult-to-Treat Asthma: A Retrospective Study

BACKGROUND AND OBJECTIVES

Large airway obstruction is well described as a cause of apparent asthma, unresponsive to the standard asthma therapy. Our purpose is to introduce multiple variants of other diseases that mimic asthma with failure to treat.

METHODS

Between the years 2005 and 2008, clinical data from 16 patients with difficult-to-treat asthma (from 3200 patients who were evaluated in our ward for any reason) were reviewed at Massih Daneshvary Hospital.

RESULT

Of the 16 patients, 5 were men and 11 women. Mean age was 40.43 years (40.43±SD=16.49). Dyspnea was present in 93.75% of the patients. Chest x-ray was normal in 62.5% of patients. Computerized tomography scan was normal in 18.75% of the patients. Endobronchial lesion was found in 87.5% of patients in which 50% was benign and 50% malignant. Vocal cord dysfunction was found in 6.25% of the patients whereas 6.25% had external pressure on tracheal lumen. Mean duration of asthma treatment was 23.8 months (range, 3 to 96 mo).

CONCLUSIONS

Asthma masqueraders include several conditions that may confound a correct diagnosis of asthma. A careful clinical examination, high index of suspicion, and appropriate analysis of spirometry are essential for the appropriate diagnosis and management of asthma. If there is no improvement after appropriate treatment, further evaluation should be performed.

Imaging features of glomus tumors

OBJECTIVE

To describe the imaging findings with pathologic correlation and clinical presentation of glomus tumors.

MATERIALS AND METHODS

We retrospectively searched the surgical pathology database from January 1, 1997, to April 30, 2010, for cases of pathologically proven glomus tumor. Patients who had imaging results available for review were included in the study.

RESULTS

Glomus tumors presented with a prolonged history of focal and often debilitating pain, with a mean duration of symptoms of 7.2 years. Mean tumor size was 13 mm. The upper extremity was involved in 12/25 (48%) of the tumors, the lower extremity in 12/25 (48%), and one case (4%) was within the trachea. Lesions appeared well circumscribed on ultrasonography, with marked vascularity on color Doppler evaluation. Magnetic resonance imaging (MRI) with a marker placed in the region of point tenderness was the best method for identifying small glomus tumors. These tumors had a high T2 signal and uniform enhancement after gadolinium administration.

CONCLUSIONS

The diagnosis of glomus tumor is suggested by imaging features of a small circumscribed mass at the site of point tenderness that show marked vascularity on Doppler evaluation or diffuse contrast medium enhancement on MRI, or both. Early tumor recognition allows surgical resection that completely resolves the crippling, chronic pain of these lesions.

Mediastinal glomangioma: CT and octreotide scintigraphy appearance, and review of the literature

The glomus body is a neuromyovascular, arteriovenous structure primarily found in the skin and, less commonly, other organs, and is involved with thermoregulation. Neoplasms of the glomus organ are most commonly encountered in the skin and soft tissues of the extremities, particularly the subungual region. Glomus tumors are rare vascular neoplasms originating from the glomus body resulting from proliferation of modified muscle cells within this organ. Glomus tumors are commonly subdivided, based on the prominence of glomocytes, vascular structures, and smooth muscle cells, into solid glomus tumors (the most common variant), glomangioma, and glomangiomyoma. Previous reports of intrathoracic glomus tumors have shown that these tumors are most commonly encountered within the tracheobronchial tree or pulmonary parenchyma; mediastinal lesions are exceptionally rare. On the basis of imaging appearance of the glomangioma reported in this case as well as prior reports of tracheobronchial and pulmonary glomus tumors, mediastinal glomus tumors manifest as intensely enhancing masses with circumscribed or poorly defined margins, closely resembling thymic carcinoid tumor, pheochromocytoma, or hypervascular lymphadenopathy. Secretion of catecholamines and tracer uptake on Indium-111 octreotide scintigraphy, as seen in the present case, is probably exceptional. Because glomus tumors may be difficult to diagnose on routine histopathologic specimens, radiologists should be aware of this rare lesion and consider the diagnosis of glomus tumor when an intensely enhancing mediastinal mass is encountered.

[Pleomorphic adenoma of the trachea. Case report]

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.

Tracheal myxoma: a rare benign tracheal tumor

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.