Sudden Death Caused by Fibrovascular Esophageal Polyp

Abstract

Benign tumors of the esophagus are rare but can lead be fatal when aspirated into the upper airway. Here, we describe a sudden death due to aspiration of a fibrovascular polyp supported by a review of 11 cases from the literature.

Giant Fibrovascular Polyp of the Esophagus

“…5,6 Recently, a case of sudden death owing to aspiration of a GVFP has been reported, bringing the total number of reported deaths since 1854 from this lesion to 12. 7 Clinical diagnosis is challenging, and polyps may be missed with endoscopic and radiologic examination. This is in part due to the normal appearing mucosal surface, which gives the appearance as part of the normal esophageal wall.…”

Hypopharynx giant fibrovascular polyps

“…These early symptoms are nonspecific and might lead to misdiagnosis. According to the Ramalho et al's report [4], showed that the average age for FVP to occur is 57.5 years. Where 64% of patients had dysphagia, 31% of patients had respiratory symptoms and 41% of patients suffered from esophagus reflux [3,4].…”

“…According to the Ramalho et al's report [4], showed that the average age for FVP to occur is 57.5 years. Where 64% of patients had dysphagia, 31% of patients had respiratory symptoms and 41% of patients suffered from esophagus reflux [3,4]. Furthermore, many papers reported that FVP is one of the causes of sudden onset of suffocation [4,6,7].…”

“…Due to weakness of muscles and the pressure during eating, loose mucosa prolapsed by gravity and elongate endoluminally from continuous peristaltic movements, leading to the mucosal and submucosal nodules valgus fold thickening and subsequent proliferative lesions [2,3]. Because of the dormant origination and the nature of slow growth [4], hypopharyngeal FVP is often asymptomatic and overlooked for years. This paper reports one recent case of giant hypopharyngeal FVP, along with the review of other cases of our center.…”

Dramatic presentation of a giant fibrovascular polyp of Laimer's triangle

“…Several endoscopic resections have been reported, with only three cases requiring a conversion to an open approach. Concerns have been raised regarding potential for massive haemorrhage using the endoscopic approach, but such complications have not been reported. LASER resection has been described.…”