Successful Treatment of Extensive Esophageal Squamous Papillomatosis With Cryotherapy

Abstract

Esophageal squamous papilloma is a rare endoscopic finding, and esophageal squamous papillomatosis (ESP) is considered exceptionally rare, with only a limited number of cases reported to date. There is a paucity of literature about the management of these lesions, and it remains largely controversial. We report a 61-year-old man who presented for endoscopic treatment of ESP detected during endoscopic evaluation for heartburn. Given the potential risk of malignant transformation, a decision was made to proceed with spray cryoablation, requiring a total of 3 sessions of ablative therapy. The histopathological assessment confirmed the diagnosis, and the specimens tested negative for all low- and high-risk human papillomavirus subtypes. Follow-up endoscopies revealed near-complete resolution. To our knowledge, the present report describes the second successful treatment of ESP using endoscopic spray cryotherapy.

Oesophageal squamous papilloma: a rare finding on oesophago-gastro-duodenoscopy with malignant potential

“…The role of gastro-oesophageal reflux is supported by observations of OSP arising in the distal oesophagus where chronic irritation with refluxing gastric acid occurs [ 1 ]. Other chemical and mechanical factors such as caustic injury, nitrosamine exposure, smoking, alcohol, prolonged nasogastric intubation, and also previous oesophageal dilatation, have been associated with OSP [ 7 ]. HPV has been detected in OSP in several studies, with a prevalence of 10–80% reported in the literature [ 4 , 5 , 8 , 9 ].…”

Esophageal squamous papilloma: an esophageal anomaly case report and review

“…4 Treatment for ESP is usually only used in symptomatic cases because of the low risk of malignancy. 7 Several treatment options include snare polypectomy, cautery, biopsy forceps, radiofrequency ablation, and endoscopic mucosal resection. 5,6,7 Recurrence following removal of the lesion is rare.…”

“…7 Several treatment options include snare polypectomy, cautery, biopsy forceps, radiofrequency ablation, and endoscopic mucosal resection. 5,6,7 Recurrence following removal of the lesion is rare. 2 A small number of cases have developed into squamous cell carcinoma if untreated.…”

“…5 The rare patients with multiple lesions (esophageal squamous papillomatosis) should be treated with esophagectomy because these cases are associated with much higher rates of eventual malignancy. 7 Esophageal squamous papillomatosis lesions are extremely rare with only approximately 12 cases reported in the literature. 6…”

Diffuse Esophageal Squamous Papillomatosis: A Rare Disease Associated with Acanthosis Nigricans and Tripe Palms

“…Owing to the paucity of case reports, there are no standard therapeutic or surveillance guidelines for its treatment or follow-up. Treatment modalities include biopsy, excisional biopsy, mucosectomy, argon plasma coagulation [ 7 ], and cryoablation [ 8 ].…”