Giant fibrovascular polyp of the esophagus

Abstract

Fibrovascular polyps of the esophagus are benign, pedunculated tumors that consist mostly of connective tissue and can reach impressive sizes. They arise from the upper third of the esophagus and may produce symptoms of dysphagia, progressive weight loss and regurgitation. The most serious clinical presentation is asphyxia secondary to laryngeal obstruction. Despite their size, diagnosis may be difficult. The location of the stalk and the vascularity makes surgical resection the preferred mode of removal of these unusual polyps.

Endoscopic Removal of a Giant Fibrovascular Polyp of the Esophagus

“…5 Leiomyomas are the most common intramural lesions, and fibrovascular polyps are the most common intraluminal lesions. 5,6 Fibrovascular polyps are pedunculated tumors that usually arise from the cervical esophagus, posterior to the cricoid cartilage and just inferior to the cricopharyngeus muscle. 4,5 They may be indolent and slow-growing, increasing in size to reach "giant" proportions.…”

“…One theory is that the lesion originates from the loose submucosal tissue of the cervical esophagus and elongates because of the propulsive forces of swallowing and peristalsis. 1,4,6 A second theory is that since fibrovascular polyps are a mixture of different tissue elements, they could represent hamartomas of the lamina propria that slowly enlarge over time. 4 More than 75% of the cases reported were greater than 7 cm at the time of presentation.…”

“…6,10 However, it is commonly recommended that polyps greater than 8 cm in size be removed by an open approach. 6 Our experience suggests that size is not a contraindication to endoscopic removal. CONCLUSIONS Giant fibrovascular polyps of the esophagus are life-threatening because of potential airway obstruction.…”

A Case of Large Fibrovascular Polyp of the Stomach

“…It generally occurs in middle-aged or elderly males, although some cases have occurred in children, infants, and women 2,3. It occurs mostly in the upper cervical esophagus, hypopharynx, and occasionally in the oropharynx 4,5. However, a report of FVP arising from stomach has not been published.…”

Dysphagia caused by a fibrovascular polyp: a case report

“…Due to peristaltic activity and traction the evagination increases to a giant polyp up to 25 cm in length [ 3 ]. Histopathologically, the polyp exists of fibrovascular connective tissue with fatty cells and is covered with squamous epithelium [ 4 ].…”