Successful Resection of locally infiltrative Glomus Tumor without pulmonary resection

Abstract

Introduction: Extracutaneous glomus tumors occurring in the bronchus is very rare. Complete resection is basic procedure for treatment of glomus tumor. We present a glomus tumor of the left main bronchus that was successfully treated with rigid bronchoscopy followed by sleeve resection of the left main bronchus.

Presentation of case: A 56-year-old man underwent two term resections to glomus tumor that originated from the left main bronchus. Firstly, we performed palliative resection with rigid bronchoscopy to make the correct diagnosis and evaluate the extent of the tumor. We subsequently performed curative resection. No complications or recurrence has occurred since the operation took place one year ago.

Discussion: Before curative resection, it is important to confirm the diagnosis and spread of the tumor. Therefore, palliative tumor resection by rigid bronchoscopy was useful to make the correct diagnosis, evaluate the extent of the tumor and open the bronchial lumen. After bronchoscopic treatment, curative pulmonary resection was performed and preservation of lung function was successful.

Conclusion: Two term resections enabled us to make an accurate diagnosis and evaluation, thereby preserving respiratory function without pulmonary resection.

Keywords: Glomus tumor; Rigid bronchoscopy; Two term resection.

Fig. 1

Chest CT on admission. Chest CT showed a polypoid tumor arising from the membranous portion of the left main bronchus (Fig. 1a,b).

Fig. 2

Bronchoscopic findings. Preoperative bronchoscopic image, the tumor almost completely obstructing the left main bronchus (Fig. 2a). After removal of the tumor by rigid bronchoscopy (Fig. 2b). Bronchoscopic image, one month after operation (Fig. 2c).

Fig. 3

Pathological findings. Pathological examination. A well-circumscribed tumor in the bronchial wall (Fig. 3a), and tumor tissues were composed of dilated, cavernous hemangioma-like vessels, surrounded by clusters of small, uniform, and rounded cells with a round nucleus and amphophilic to lightly eosinophilic cytoplasm (Fig. 3b). Scale bar: 2 mm (Fig. 3a); 50 μm. (Fig. 3b)