Extramural recurrence of tracheal glomus tumour following resection by rigid bronchoscopy

Abstract

Glomus tumour of the trachea is very rare neoplasm that is generally benign and arises most commonly from the distal portion of the respiratory tree. This report presents the case of a 67-year-old man who was referred to our institute for excision of a tracheal mass that had been found incidentally, and subsequently recurred extramurally. Initial contrast-enhanced computed tomography images of the chest revealed a nodular lesion in the trachea, 2.5 cm above the carina, that demonstrated strong enhancement similar to blood vessels. The tumour was excised by rigid bronchoscopy, but an extramural tracheal lesion was detected 18 months later. Tracheal resection and end-to-end anastomosis were performed, and histopathological examination confirmed the extramural lesion as recurrence of the tracheal glomus tumour. The histologic features and treatment are discussed.

Keywords: rigid bronchoscopy; tracheal glomus tumour; tracheoplasty.

FIGURE 1

(A and B) Coronal computed tomography (CT) and virtual bronchoscope images of the chest demonstrates a 1.5 cm mass protruding into the lower trachea before endoscopic treatment. (C) The lesion shows strong contrast enhancement similar to that of blood vessels on post‐contrast axial CT before endoscopic treatment. (D) Image from bronchoscopy performed 3 months after endoscopic removal of the lesion reveals no obvious abnormalities.

FIGURE 2

(A) Follow‐up computed tomography (CT) at 18 months after endoscopic removal of the lesion. Axial CT image of the chest shows an extramural lesion in the lower trachea. (B) Macroscopic image of the surgically resected tumour shows a 1.2 × 0.6 cm lesion with extramural protrusion. (C) Histopathological slide shows lobular arrangement of oval‐to‐spindle‐shaped cells with uniform, clear or pale eosinophilic cytoplasm and hyperchromatic nuclei. (haematoxylin and eosin, ×400). Scale bar indicates 20 μm.