Fibrovascular polyp of the esophagus requiring esophagectomy
University of Southern California, Department of Cardiothoracic Surgery, Los Angeles, California 90033, USA. Diseases of the Esophagus
(Impact Factor: 1.78).
02/2007; 20(5):453-4. DOI: 10.1111/j.1442-2050.2007.00710.x
Fibrovascular polyps of the esophagus are rare, with only 110 cases reported in the world literature to date. Dysphagia is the most common symptom. The diagnosis is usually made by barium swallow or upper endoscopy, but almost a third of cases can be missed with these studies. Treatment is surgical. Only four cases in the literature underwent esophagectomy for removal. We present a female patient with a fibrovascular polyp of the esophagus who required a transhiatal esophagectomy to safely remove this mass.
Available from: PubMed Central
- "They usually arise in the proximal oesophagus behind the cricoid cartilage, frequently from the upper oesophageal sphincter. These polyps usually originate as small mucosal tumours just below the cricopharyngeus muscle sphincter, then extend into the oesophageal lumen by the constant downward urge of both food and peristalsis, and they may reach into the stomach [6,7]. The incidence of these tumours is highest in middle-aged and elderly men, although some cases have occurred in children, infants, and women. "
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ABSTRACT: We present a case of fibrovascular polyp, a rare submucosal tumour of the oesophagus that has been reported only sporadically in the literature. The biapproach for surgical removal of fibrovascular polyp has only been mentioned once in the literature.
A 65-year-old Greek man presented with a 9-month history of gradually progressive intermittent dysphagia. Radiologic work-up with oesophagogram and computed tomography revealed a large, sausage-shaped intraluminal polyp extending from the level of the cervical oesophagus to the level of the upper body of the stomach. The diagnosis of giant fibrovascular polyp was made radiographically and confirmed by endoscopic biopsy. The polyp was removed using a biapproach surgical technique: pharyngotomy and subsequent gastrostomy.
Fibrovascular polyp is a rare submucosal tumour. Proper treatment depends on accurate assessment of the origin, size, and vascularity of the pedicle and the size of the tumour. Choice of the appropriate surgical approach depends on the correct diagnosis, which can usually be indicated radiographically by the presence of a smooth, sausage-shaped defect with a discrete bulbous tip.
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ABSTRACT: Polysegmented fibrovascular polyps are relatively rare benign neoplasms of the esophagus. They frequently reach giant sizes before patients develop symptoms and a diagnosis is made. Appropriate treatment of these polyps is endoscopic or surgical excision. In this paper we report a case in which an 86-year-old man regurgitated a giant polypoid mass into his mouth that led to dyspnea and dysphagia. The polyp was successfully removed by a transoral approach, by minimally invasive surgery, by use of a monopolar laparoscopic electrosurgical instrument (Valleylab LigaSure Advance™ Pistol Grip). The patient was symptom and recurrence-free at 6-month follow-up.
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