einstein (São Paulo). 25/jun/2024;22(Suppl 1):STO012.

Tracheal glomus tumor resection with cervicotomy and right thoracotomy: case video

Flavia Alves Corrêa de

Queiroz

, José de Sá Moraes

Neto

, Jaqueline Schaparini

Fonini

, Isabele Alves

Chirichela

, Benoit Jacques

Bibas

, Helio

Minamoto

, Paulo Manuel

Pêgo-Fernandes

DOI: 10.31744/einstein_journal/2024ABS_BTS_STO012

Category: Thoracic Oncology

Introduction:

Glomus tumors (GTs) are rare mesenchymal tumors typically developing at the anastomosis of arteries and veins, and generally characterized as benign.⁽⁾ They represent less than 2% of all soft tissue tumors, commonly affect nail beds, extremities, the torso, head and neck. Their occurrence in the trachea is unusual, with around 80 cases reported in literature, commonly occurring in middle-aged individuals, with an average age of 48.8 years, and more prevalent in men than women.^(,)

Objective:

In this video, we present a case of tracheal glomus tumor (TGT), as well as the resection technique used in our department.

Case video Summary:

A 67-year-old man, with a 30 pack-year history of cigarette smoking was admitted for a one-year history of cough, dyspnea and hemoptysis. Bronchoscopy identified a solid tumor, originating from the right lateral wall of the lower trachea with 80% obstruction and a rich blood supply. Chest computed tomography (CT) confirmed a 2.6 x 2.4 x 2.2 cm vegetative lesion located 6.2 cm below the vocal cords and 2.5cm above the carina. Patient underwent resection and tracheoplasty under general anesthesia and selective left intubation guided with bronchoscopy. Procedure began in the supine position with cervicotomy including previous tracheostomy site, release of adhesions and dissection of the anterior fascia. After the closure of incision, proceeded to left lateral decubitus with right posterior thoracotomy in the third intercostal space, added a 10mm auxiliary incision in the tenth right intercostal space (RIS) for the 10mm/30° thoracoscope and an incision at the seventh RIS. In the dissection, we opened the mediastinal pleura, dissected the anterior, lateral and posterior of trachea and proceeded the regional lymphadenectomy. After that, the pericardium was opened near the pulmonary hilum and furthermore released the inferior pulmonary ligament to improve mobilization.

Conclusion:

In this article, we present a detailed case of a tracheal glomus tumor, highlighting the clinical presentation, diagnostic process, and the resection technique employed in our department. Our approach underscores the importance of accurate diagnosis and effective surgical intervention with radical resection in managing this rare condition.