Glomus Tumors of Uncertain Malignant Potential Arising in the Endobronchus and Lung Parenchyma

Pulmonary glomus tumors are rare, and synchronous endobronchial and pulmonary parenchymal lesions are particularly uncommon. A 72-year-old woman was admitted with a 20-day history of cough and blood-streaked sputum. Contrast-enhanced chest computed tomography demonstrated a 25 × 20 mm solid nodule in the apicoposterior segment of the left upper lobe and a 13 × 8 mm endobronchial nodule in the left upper-lobe bronchus. Both lesions had smooth margins, prominent vascularity, and persistent enhancement. Bronchoscopy showed complete obstruction of the left upper-lobe bronchus by a smooth intraluminal mass. Electrosnare resection with electrocoagulation was performed, and pathology indicated a glomus tumor of uncertain malignant potential. Because a small endobronchial remnant was suspected, the parenchymal lesion showed the same histology, and local treatment could not ensure complete resection, a multidisciplinary team recommended video-assisted thoracoscopic left upper-lobe sleeve resection. The resection specimen contained a 2.5 × 2.5 × 2.3 cm mass adjacent to and protruding into the bronchus. Bronchial margins, visceral pleura, and dissected lymph nodes were free of tumor. Immunohistochemistry showed positivity for cytokeratin, desmin, smooth muscle actin, and vimentin; together with the morphology, these findings supported the diagnosis of glomus tumor. The patient recovered uneventfully and remained clinically stable during the reported follow-up. Hypervascular endobronchial or pulmonary parenchymal nodules with persistent enhancement should prompt consideration of a pulmonary glomus tumor, although definitive diagnosis requires morphologic and immunophenotypic assessment. When pathology indicates uncertain malignant potential with multifocal disease or a risk of residual tumor, treatment should balance oncologic completeness, preservation of pulmonary function, and long-term imaging surveillance.