Behavior of primary tracheal glomus tumor, uncertain malignant potential subtype

Multislice helical computed tomography imaging diagnosis and surgical treatment of primary tracheal tumor in cardiothoracic surgery

Objective

it aimed to explore the value of multislice helical computed tomography (MSCT) in the diagnosis and surgical treatment of primary tracheal tumors.

Methods

64 patients with the primary tracheal tumor who were diagnosed in Wuxi Second People's Hospital from March 2020 to March 2021 were selected as the research objects. MSCT imaging was performed on all patients, and suitable surgical methods. The pathological results were compared with original CT, CT virtual endoscopy (CTVE), and Comparisons were made using CT three-dimensional reconstruction images to evaluate the accuracy of MSCT diagnosis. Parameters such as postoperative complications and survival rates were observed to assess surgical effectiveness and safety.

Results

Compared with original CT images (70%, 72%, 70%), the diagnostic accuracy of VR images (80%, 80%, 80%), MPVR images (85%, 90%, 92%), and CTVE images (100%, 100%, 100%) was remarkably improved (P<0.05). The three-year survival rate of patients with smooth muscle tumors, malignant tumors, salivary gland adenoma, papillary tumors, and inflammatory polyp was markedly lower than that of the one-year survival rate, with a significant difference (P<0.05). The incidence of postoperative complications was 14.1%, with three cases resulting in complication-related deaths.

Conclusion

the diagnostic accuracy of MSCT imaging of primary tracheal tumor was high. The diagnostic accuracy of CTVE was higher than that of VR and MPVR. Besides, surgical treatment of primary tracheal tumor had a substantial effect, with no serious postoperative complications.

Pulmonary Glomus Tumor

Glomus tumors, which account for less than 2% of soft tissue tumors, are a rare benign soft tissue neoplasm. They originated from neuro-myo-arterial glomus tissue whose primary function is regulation of the body temperature. This tissue is commonly located in the dermis or subcutis in the subungual region; however, it can be extracutaneous such as in bones, the genitourinary tract, the gastrointestinal tract, and the respiratory tract. Histologically, a glomus tumor is made of proliferating rounded or cuboidal epithelioid cells in a meshwork of blood vessels. Although a benign growth, they can rarely show malignant features with infiltration of surrounding tissue with the rapid multiplication of cells in which case it is labeled as a malignant glomus tumor. Pulmonary glomus tumors are extremely rare and most commonly occur in middle-aged men. They are mostly asymptomatic, but a small percentage of patients may present with hemoptysis and cough if there is large airway involvement. We present an interesting case of a middle-aged man presenting with cough and occasional hemoptysis, found to have an endobronchial nodular lesion, and subsequently diagnosed with a pulmonary glomus tumor.

Tracheal Glomus Tumor Complicated with Asthma Exacerbation in a Pregnant Woman

A 34-year-old pregnant woman in the 34th week of gestation with uncontrolled asthma was admitted because of asthma exacerbation. Although she received bronchodilators and systemic corticosteroids, respiratory failure rapidly progressed. Chest computed tomography revealed a mass occluding approximately 80% of the tracheal lumen. After urgent Caesarean section, endobronchial resection was performed. The pathological findings of the resected tumor were compatible with tracheal glomus tumor. Tracheal tumors are often misdiagnosed as asthma, but its complication with asthma is rare. Even if the diagnosis of asthma is definitive, clinicians should consider coexisting diseases, including tracheal tumors, when asthma control is poor.

Case Report: The first case of primary pulmonary collision tumor comprising mixed squamous cell and glandular papilloma and glomus tumor

A collision tumor is a rare entity, particularly if occurring in the lung. We report a case of a 57-year-old woman with a primary pulmonary collision tumor comprising mixed squamous cell and glandular papilloma (MSGP) and glomus tumor (GT). An abnormal mass was discovered in the right lung by computed tomography (CT) of the chest. A right lower lobectomy with mediastinal lymph node dissection was performed. Histological examination of the surgical specimen suggested that the lung cancer was composed of two neoplastic components. To the best of our knowledge, this is the first report of a primary pulmonary collision tumor comprising two benign tumors of different origins, which were MSGP and GT.

Tracheal Glomus Tumor: A Case Report with CT Imaging Features

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.