Extracutaneous glomus tumors are unusual and their occurrence in the trachea has been recognized with extreme rarity. We present a case of surgically resected glomus tumor of the trachea in a 54-year-old woman who was initially misdiagnosed as having bronchial asthma because of expiratory wheezing. The tumor, located 7 cm below the vocal cord and 5 cm above the carina, was an intraluminally protruding polypoid mass that measured 1.5 X 1.2 cm and arose from the posterior wall of the trachea with a broad base. Microscopically, the tumor was predominantly of the solid type, but a small proportion of a glomangiomatous component was admixed. Ultrastructural study confirmed the presence of myofibrillar bundles with focal densities and fine pinocytotic vesicles along the plasma membrane. A structure similar to a nonneoplastic glomus was demonstrated in the submucosal layer of the posterior wall away from the tumor margin. This suggests that the tracheal glomus tumor occurs more often in the posterior wall where neuromuscular complex structures may develop more readily.
Cancer 642381-886. 1989.
HE GLOMUSTUMOR is a distinctive neoplasm arising T in cells resembling the modified smooth muscle cells of the normal glomus body.' Its estimated incidence rate in the 500 consecutive soft tissue tumors is 1.6%.' It is distributed most commonly in the subungual region of the finger, but other common sites include the palm, wrist, forearm, and foot.' In fact. it is now recognized that the tumor also may develop in sites where the normal glomus body may be sparse or even absent. Unusual locations listed include the patella, chest wall, bone, heart, stomach, eyelid, nasal cavity, mediastinum, lung. rectum, uterus, vagina, labia, and mesentery.'-3 Of the benign neoplastic lesions protruding into the lumen of the trachea, the papilloma is the most common tumor.4 Several mesenchymal tumors have been described, but only two instances of tracheal glomus t ~m o r ~. ~ have been documented. This report describes the pathologic characteristics of a polypoid glomus tumor protruding into the lumen of the trachea and causing symptoms mostly through the mechanical effects of partial airway obstruction. Also, an attempt is made to explain the preferable occurrence of this tumor in the posterior wall of the trachea.