Giant Fibrovascular Polyp of the Larynx

Nascimento, Silva Bona do; Santos, Flávio Carvalho; Pinheiro, Mariana de Novaes Santos Magalhães

doi:10.1055/s-0033-1364171

Cited by 6 publications

(6 citation statements)

References 7 publications

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“…Giant fibrovascular polyps (GFVPs) are rare benign tumors that can be found in the esophagus or, rarely, in the hypopharynx or larynx. [ 1 , 2 ] The differential diagnosis for a fibrovascular polyp (FVP) includes lipoma, hamartoma, inflammatory polyp, hemangioma, lymphangioma, schwannoma, carcinoid tumor, chemodectoma, [ 3 ] and achalasia. [ 2 ] FVPs can only be definitively diagnosed upon histopathological evaluation.…”

Section: Introductionmentioning

confidence: 99%

“…[ 1 , 2 ] The differential diagnosis for a fibrovascular polyp (FVP) includes lipoma, hamartoma, inflammatory polyp, hemangioma, lymphangioma, schwannoma, carcinoid tumor, chemodectoma, [ 3 ] and achalasia. [ 2 ] FVPs can only be definitively diagnosed upon histopathological evaluation. [ 2 ] If the specimen does not fulfill the histopathological criteria for a FVP, then an alternative diagnosis should be considered.…”

Section: Introductionmentioning

confidence: 99%

“…[ 2 ] FVPs can only be definitively diagnosed upon histopathological evaluation. [ 2 ] If the specimen does not fulfill the histopathological criteria for a FVP, then an alternative diagnosis should be considered.…”

Section: Introductionmentioning

confidence: 99%

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An atypical lipomatous tumor mimicking a giant fibrovascular polyp of the hypopharynx

Ioanidis

MacNeil²,

Tay³

et al. 2017

Medicine

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Rationale:Giant fibrovascular polyps (GFVPs) found in the hypopharynx are exceedingly rare. These are benign tumors which are identified by CT or MRI and usually treated based on symptoms. Even more rarely, pathology may identify one of these masses as an atypical lipomatous tumor (ALT). This paper will present a case of an ALT of the hypopharynx that was originally classified as a GFVP, highlighting the difficulty in distinguishing between them and the importance of making the correct diagnosis.Patient Concerns:An 84-year-old man presented to the emergency department with a 6-month history of a pedunculated hypopharyngeal growth, dysphagia, and intermittent dyspnea.Diagnoses:The mass was characterized as a GFVP by barium swallow and MRI.Interventions:The hypopharyngeal mass was resected for obstructive symptoms and to confirm the diagnosis. Final pathology found the mass to be more consistent with an atypical lipomatous tumor (ALT).Outcomes:The patient's dysphagia and dyspnea resolved. He was free of recurrence at 22 months postoperative.Lessons:Both GFVPs and ALTs are very rarely found in the hypopharynx but can be easily misclassified as one another. Imaging is useful to initially characterize the mass, but to definitively differentiate between them, pathological analysis is necessary. Although they are rare, it is important to consider both possibilities on the differential for hypopharyngeal masses. Further, accurate analysis is essential to distinguish between them because their definitive management and follow-up is different.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An atypical lipomatous tumor mimicking a giant fibrovascular polyp of the hypopharynx

Ioanidis

MacNeil²,

Tay³

et al. 2017

Medicine

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“…1,2 Most originate from the upper third of the esophagus; only a few cases of giant hypopharyngeal polyps have been described to date and only 1 case arising from the pharyngoepiglottic fold. 3,4 The most frequent symptom is progressive dysphagia, followed by regurgitation of the mass into the mouth with the risk of aspiration into the airways. Other symptoms include pharyngeal globus, weight loss, gastroesophageal reflux, odynophagia, and infrequently melena and anemia.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Cause of Anemia and Positive Fecal Occult Blood Test Screening

Pavić

Grgić

Schmidt

2017

JAMA Otolaryngol Head Neck Surg

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A man in his 70s with long-standing diabetes, coronary artery disease, and chronic renal failure presented with edema of the right lower leg and suspected venous thrombosis (which was not confirmed by subsequent Doppler ultrasonography). Blood tests revealed serious iron deficiency anemia (hemoglobin level, 8.6 g/d [86 g/L]) and a positive result for a fecal occult blood test. His appetite was intact; he had not lost weight; and no dysphagia, stomach pain, or stool irregularity was reported. Initially, we performed an upper endoscopy that revealed normal esophageal mucosa with folding of the posterior esophageal wall through the entire length of the esophagus. Distal ending of the folding was not clearly seen in forward viewing, but in retroflexion, a necrotic polypoid lesion was observed protruding from the esophagogastric junction. A computed tomographic scan of the chest with oral contrast revealed an esophageal intraluminal tubular mass of soft-tissue density, about 15 mm in diameter originating just below the pyriform recessus and extending through the esophagus in the stomach lumen for about 20 mm (Figure 1). The patient was referred to an ear, nose, and throat specialist who performed esophagoscopy of the hypopharynx with the patient under endotracheal anesthesia. Figure 1. Intraluminal tubular mass extending through the entire esophagus. CT indicates computed tomographic.

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“…About 85 % of FVPs are located in the cervical esophagus (Kim and Shim 2006 ). In addition, rare cases arising from the oropharynx, larynx, or stomach have also been reported (Caceres et al 2006 ; Lee et al 2013 ; Nascimento et al 2014 ; Gupta et al 2011 ). Their exact etiologies are not well known.…”

Section: Discussion and Evaluationmentioning

confidence: 99%

Giant fibrovascular polyp in the hypopharynx: a case report and review of the literature

et al. 2016

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IntroductionFibrovascular polyps (FVPs) are benign tumors that commonly occur in the cervical esophagus. Few cases of FVPs of the hypopharynx have been reported, but there has been no English review concerning hypopharyngeal FVPs (hFVPs). Here, we report a case of a vast hFVP, and we also review 13 hFVP cases found in the English literature (PubMed search) including our case.Case descriptionA 41-year-old man with respiratory distress and regurgitation of a mass was referred to our hospital. Endoscopic and radiographic evaluations were required for diagnosis. The tumor originated from the hypopharynx and covered almost the entire larynx, which caused the airway to narrow. An emergency surgical removal was performed under general anesthesia with orotracheal intubation, and the tumor was completely removed transorally using a laryngeal endoscope. Pathological examination revealed that the mass was a FVP.Discussion and EvaluationWe investigated patient characteristics, symptoms, polyp size, treatments, and recurrence of 13 hFVP cases. Regurgitation of a mass, dyspnea, and dysphagia were frequently reported symptoms at presentation. All patients were treated by surgical excision with no recurrence. Airway management is critical and tracheotomies were needed in some cases.ConclusionsFVPs are often asymptomatic, and they can suddenly cause respiratory distress from laryngeal blockage. Therefore, we emphasize that when such cases are encountered, airway management and surgical treatment should be considered as early as possible.

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Giant Fibrovascular Polyp of the Larynx

Cited by 6 publications

References 7 publications

An atypical lipomatous tumor mimicking a giant fibrovascular polyp of the hypopharynx

An atypical lipomatous tumor mimicking a giant fibrovascular polyp of the hypopharynx

An Unusual Cause of Anemia and Positive Fecal Occult Blood Test Screening

Giant fibrovascular polyp in the hypopharynx: a case report and review of the literature

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