Tracheal Glomus Tumor: A Case Report with CT Imaging Features

Abstract

Background and objectives: Glomus tumors are rare benign tumors. The majority of them affect the skin the most and are rarer in the trachea, where the glomus bodies may not be present. Only scarce reports of tracheal glomus tumors have been reported solely with case reports of relevant articles.

Materials and methods: A 53-year-old man, with a free previous medial history, presented to our hospital with tracheal mass which was incidentally found. He did not complain of any specific symptoms associated with the tracheal tumor. The contrast-enhanced chest computed tomography (CT) revealed an avid enhancing nodular lesion, which is similar to blood vessels, in the trachea, 3 cm above the carina level without definite airway obstruction.

Results: Successful tracheal resection and end-to-end anastomosis were performed on the patients; therefore, the final post-operative pathologic findings revealed a benign tracheal glomus tumor. The follow-up CT scan four months after operation showed complete removal of the tumor.

Conclusion: Tracheal glomus tumors, even rare entities, could be considered as a differential diagnosis if a highly enhancing mass appears on CT images.

Keywords: bronchoscopic biopsy; computed tomography.

Figure 1

53-year-old male with tracheal glomus tumor. (A) CT lung window setting images; (B) pre-contrast enhanced image; (C) post-contrast enhanced image; and (D) coronal post-contrast enhanced image. (A) The lung window setting CT image showed a 1.4 × 1.3 cm sized protruding mass in the right posterior wall of the mid trachea; (B,C) on contrast CT images, the lesion exhibited a high contrast enhancement similar to that of blood vessel; (D) the coronal post-contrast-enhanced CT image showed the lesion was located 3 cm above the carina and did not obstruct the airway.

Figure 2

Bronchoscopy revealed a 1.5 cm sized polypoid endotracheal mass with a hyperemic mucosal surface in the mid portion of the trachea.

Figure 3

The histopathological findings after surgery showing typical features of tracheal glomus tumor. (A) The tumor consisted of a proliferation of epithelioid cells and abundant vascular channels (hematoxylin and eosin [H&E], ×200); (B) tumor cells were abundant, single, round, and small-sized, with uniform eosinophilic or transparent cytoplasm and hyperchromatic nuclei and formed microvascular spaces (H&E, ×400); (C–F) immunohistochemistry showed tumor cells were diffusely positive for smooth muscle actin (SMA), focally positive for synaptophysin (Syn), but negative for CD56 and CD31 (c; SMA, ×100, d; Syn, ×100, e; CD56, ×100, f; CD31 ×100).