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Acharya S, Anwar S, Thapa K, Thapa S, Lau M. Pulmonary Glomus Tumor. Cureus 2023; 15:e38684. [PMID: 37292573 PMCID: PMC10246930 DOI: 10.7759/cureus.38684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 06/10/2023] Open
Abstract
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.
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Affiliation(s)
- Sudeep Acharya
- Pulmonary and Critical Care Medicine, Staten Island University Hospital, Staten Island, USA
| | | | - Kumar Thapa
- Internal Medicine, Staten Island University Hospital, Staten Island, USA
| | - Sakura Thapa
- Internal Medicine, Green City Hospital, Kathmandu, NPL
| | - Michael Lau
- Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA
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Oide T, Yasufuku K, Shibuya K, Yoshino I, Nakatani Y, Hiroshima K. Primary pulmonary glomus tumor of uncertain malignant potential: A case report with literature review focusing on current concepts of malignancy grade estimation. Respir Med Case Rep 2016; 19:143-149. [PMID: 27752464 PMCID: PMC5061071 DOI: 10.1016/j.rmcr.2016.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/04/2016] [Accepted: 10/04/2016] [Indexed: 01/15/2023] Open
Abstract
We report a 38-year-old woman with a left lung tumor presenting as obstructive pneumonia. Bronchoscopic examination revealed a polypoid tumor filling the left main bronchus. The tumor was partially resected by a snaring procedure for diagnostic purposes. Microscopic examination revealed a submucosal tumor located underneath normal bronchial epithelium. The tumor was composed of sheets of uniform oval to cuboidal cells encompassing numerous blood vessels. Immunohistochemically, the tumor cells exhibited smooth muscle markers, but were negative for neuroendocrine markers. The diagnosis of primary pulmonary glomus tumor was therefore made. Subsequent bronchoscopic intervention allowed us to pin-point the origin of the tumor: superior segmental B6a/b. She underwent a left lower lobe superior segmental resection successfully. Glomus tumors are relatively rare soft tissue tumors, and those of bronchopulmonary origin are exceedingly rare clinical condition. Among primary lung tumors, the carcinoid tumor is a mimic of the glomus tumor, and differentiating these tumors is known to be difficult, especially using small biopsy samples. In the present case, a large tissue sample obtained by bronchoscopic snaring was quite useful for the correct preoperative diagnosis. Because of the disease rarity, malignancy grade estimation of visceral glomus tumors has not been clearly addressed. Recently, the histopathological diagnostic criteria for malignant glomus tumors was defined in the WHO classification of soft tissue and bone tumors 4th edition. Here we also reviewed the literature on primary bronchopulmonary glomus tumors with special attention to the current concept of malignancy grade estimation.
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Affiliation(s)
- Takashi Oide
- Department of Pathology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan; Department of Diagnostic Pathology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuhiro Yasufuku
- Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kiyoshi Shibuya
- Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ichiro Yoshino
- Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yukio Nakatani
- Department of Diagnostic Pathology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kenzo Hiroshima
- Department of Pathology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan; Department of Diagnostic Pathology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Krishnakumar M, Sharma R, Pawar HS, Hasnain S. Anaesthetic management of left main bronchial glomus tumour. Indian J Anaesth 2016; 60:276-9. [PMID: 27141112 PMCID: PMC4840809 DOI: 10.4103/0019-5049.179466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Glomus tumours involving bronchus are rare. Surgical resection is the treatment of choice for this tumour, with excellent prognosis. The nature and location of tumour pose a significant challenge for perioperative anaesthetic management. However, there is a paucity of case reports on anaesthetic risks involved in case of a bronchial glomus tumour. We present a case of glomus tumour involving left main stem bronchus, subjected to bronchial sleeve resection. The various anaesthetic implications of this tumour type and airway management with right double lumen tube are discussed.
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Affiliation(s)
- Mathangi Krishnakumar
- Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
| | - Rammurti Sharma
- Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
| | - Harshwardhan Singh Pawar
- Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
| | - Shahbaz Hasnain
- Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
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Abstract
We report a case of a 52-year-old patient who had undergone a bladder resection and an ileal conduit for a transitional cell carcinoma. He then presented with a short history of hemoptysis 3 months later. Rigid bronchoscopy was performed revealing an endobronchial lesion, which was removed via laser and debulking method without complications. Histopathologic examination confirmed it to be a benign endobronchial glomus tumor. On the basis of our literature search, this is the 34th reported case of glomus tumor arising from the respiratory tract, seventh reported case of an endobronchial glomus tumor treated bronchoscopically, and the first possibly coincidental finding in relation to a patient with primary transitional bladder cell carcinoma.
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Pulmonary leiomyosarcoma mimicking glomus tumor at first biopsy and surgically treated with isolated left main bronchus resection: rare clinical documentation. Ir J Med Sci 2013; 182:735-8. [PMID: 23636708 DOI: 10.1007/s11845-013-0962-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 04/22/2013] [Indexed: 10/26/2022]
Abstract
Soft tissue tumors originating within the endobronchial tree are extremely rare and most of them correspond to lipomas or leiomyomas. We here report a rare clinical presentation of leiomyosarcoma mimicking glomus tumor at initial biopsy arising from the left main bronchial trunk leading to left lower lobe atelectasis. Primary leiomyosarcoma of the lung is an unusual malignancy. Among this entity, the endobronchial form is very rare and the preoperative diagnosis is extremely difficult. We documented two different presentations and outcomes of primary endobronchial leiomyosarcoma of the lung. In this clinical presentation, histological study and immunohistochemical stain of the surgical resection provided the final diagnosis. Through the following we present the diagnostic and therapeutic difficulties encountered with endobronchial leiomyosarcoma.
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A primary pulmonary glomus tumor: a case report and review of the literature. Case Rep Pathol 2012; 2012:782304. [PMID: 23050181 PMCID: PMC3459257 DOI: 10.1155/2012/782304] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 08/05/2012] [Indexed: 11/22/2022] Open
Abstract
A case of a glomus tumor originating from the lung is reported. A 43-year-old female had undergone resection of a right lung tumor following a clinical diagnosis of carcinoid, sclerosing hemangioma, or other sarcoma. Histologically, the tumor comprised uniform small round to oval cells with centrally located nucleus, a clear cytoplasm, and apparent cell borders. The tumor also showed a focally hemangiopericytomatous pattern with irregularly branching or dilated vessels. Electron microscopy revealed smooth muscle differentiation of the tumor cells. Immunostaining further revealed that the tumor cells expressed smooth muscle actin, h-caldesmon, muscle specific actin (HHF-35), but not cytokeratin, epithelial membrane antigen, synaptophysin, or chromogranin A. Based on these findings, a diagnosis of primary pulmonary glomus tumor was established. Glomus tumors of the lung are very rare and only 21 cases have been reported to date. The histological features of the present tumor and the relevant literature are discussed.
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Kajiwara N, Kakihana M, Usuda J, Ohira T, Kawate N, Ikeda N. Interventional management for benign airway tumors in relation to location, size, character and morphology. J Thorac Dis 2012; 3:221-30. [PMID: 22263096 DOI: 10.3978/j.issn.2072-1439.2011.04.06] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 03/25/2011] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To select minimally stressful methods for patients with benign bronchial tumors, and evaluate interventional strategies in relation to location, size, character and morphology. METHODS We reviewed the indications and efficacy of various interventional bronchology techniques at our institution, including individual or combined laser resection, electrocautery, argon plasma coagulation and high radiofrequency snaring for the treatment of various types of benign bronchial tumors. RESULTS It is essential to treat endoscopically that the tumor is visible and has a stalk and not invade beyond bronchial wall. By using combined techniques, no complications or recurrences were encountered. CONCLUSIONS Interventional bronchology techniques for benign bronchial tumors can be simple and safe, and therapeutic strategies should be designed in relation to location, size, character and morphology of tumors.
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Mogi A, Kosaka T, Yamaki E, Tanaka S, Kuwano H. Successful resection of a glomus tumor of the trachea. Gen Thorac Cardiovasc Surg 2011; 59:815-8. [DOI: 10.1007/s11748-010-0772-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 12/21/2010] [Indexed: 10/14/2022]
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Azevedo-Pereira AED, Rigueiro MP, Abrão FC. Bronchial glomus tumor with right upper lobe atelectasis. J Bras Pneumol 2010; 36:390-3. [PMID: 20625678 DOI: 10.1590/s1806-37132010000300018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Accepted: 03/15/2010] [Indexed: 11/22/2022] Open
Abstract
Glomus tumors are uncommon benign soft tissue neoplasms. We report the case of a 32-year-old male who presented with right upper lobe atelectasis due to an endobronchial tumor. The patient underwent right upper lobectomy and wedge bronchoplasty. The pathological diagnosis was bronchial glomus tumor. To our knowledge, this presentation (with right upper lobe atelectasis) has never before been reported. Glomus tumor should be considered in the differential diagnosis of endobronchial lesions causing lobar atelectasis.
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Akata S, Yoshimura M, Park J, Okada S, Maehara S, Usuda J, Kajiwara N, Tsuboi M, Kato H, Kakizaki D. Glomus tumor of the left main bronchus. Lung Cancer 2007; 60:132-135. [PMID: 17905464 DOI: 10.1016/j.lungcan.2007.08.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2007] [Revised: 07/30/2007] [Accepted: 08/17/2007] [Indexed: 10/22/2022]
Abstract
We report a case of left main bronchial glomus tumor in a 39-year-old man who presented with a cough he had had for 1 month. A computed tomography (CT) scan revealed a polypoid tumor in the membranous portion of the left main bronchus. The tumor showed marked enhancement on the early phase of dynamic contrast-enhanced CT, and it was thought to be a hypervascular tumor. The tumor was carefully resected by a rigid bronchoscope, and the pathological and immunohistochemical findings yielded a diagnosis of glomus tumor. Marked enhancement of early phase dynamic contrast-enhanced CT may be useful for a diagnosis of bronchial glomus tumor.
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Affiliation(s)
- Soichi Akata
- Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
| | - Mana Yoshimura
- Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Jinho Park
- Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Shinya Okada
- Department of Pathology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Sachio Maehara
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Jitsuo Usuda
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Naohiro Kajiwara
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Masahiro Tsuboi
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Harubumi Kato
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Dai Kakizaki
- Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
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Abstract
A 41-year-old female patient presented with localized worsening subungual pain of her right index finger. Subsequent diagnostic evaluation revealed the presence of a glomus tumor. A glomus tumor is a rare tumor with a predilection for the hand. Classic symptoms include pain, pain with pressure, and pain with cold temperature. We present a completely updated literature review that addresses the epidemiology, pathology, presentation, diagnostic evaluation, classification, histology, genetics, and treatment options for glomus tumors.
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Affiliation(s)
- Santosh S Kale
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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