Giant fibrovascular polyp of the esophagus

Abstract

Background. Fibrovascular polyps of the esophagus are rare disorders that constitute less than 1% of all gastrointestinal system neoplasms. Despite being universally benign, they can be symptomatic and have serious complications. The definitive treatment is excision of the mass. In this article, we present a rare case of a giant fibrovascular polyp of the esophagus. Case presentation. A 55 year old male patient presented with symptoms of dysphagia and regurgitating mass. Diagnostic tests revealed a pedunculated submucosal mass extending through the upper esophageal lumen. Surgical excision of the mass was planned. The pedunculated mass of 10 cm length was resected through a left cervical esophagotomy The patient was discharged without complications on the postoperative fifth day. Pathological examination of the specimen revealed a giant fibrovascular polyp measuring 10x2.5x1.7 cm with stroma rich in adipose tissue and prominent vascular components. Conclusion. Benign tumors of the esophagus are rare, with an incidence of less than one percent. The most common of these tumors are fibrovascular polyps. Although usually asymptomatic, they can present with various symptoms such as dysphagia, pharyngeal or substernal mass and regurgitation. Asphyxiation and gastrointestinal bleeding are possible complications. Excision of the polyp is the definitive cure and is recommended for symptomatic patients with large polyps. Endoscopic, cervical or thoracic approach are all possible choices of management among which the decision should be made according to the size and the location of the mass. Patients’ symptoms disappear immediately after surgery. Recurrence is rare and complication rates are low.