Fibrovascular polyp of the esophagus

Abstract

Fibrovascular polyps are rare, benign, and intraluminal tumors submucosal tumor-like lesions of the proximal esophagus. Fibrovascular polyps account for only 0,5-1% of all benign esophageal tumors. Polyps of a large size are thought to be extremely dangerous due to known risk of obstruction of the respiratory tract and asphyxiation. The removal of these lesions is usually recommended because of the progressive complications of oesophagus. As for correct surgical approach, the accurate assesment of the origin, size, and vascularity of the pedicle and the size of the tumor mass is essial for the proper treatment. Surgical, rather than endoscopic removal, is the treatment of choice. In the article a case of giant fibrovascular polyp of the cervical part of esophagus is presented in 72-yr-old-men, accompanied by specific clinical manifestations: intermitting dysphagia and efforts to regurgitate. Visual examination and fibroesophagoscopy demonstrated the giant fibrovascular polyp (more than 10 cm long) in the proximal esophagus. X-ray investigation of the esophagus with barium sulfate studies failed to demonstrate a proximal pedicle. The fibrovascular polyp due to the presence of thick pedicle could not be removed via endoscopy. A cervical vertical oesophagostomy with the fibrovascular polyp resection appears to be the approach of choice. No any cases of recurrence after radical surgery according to the available literature has been reported. It is important to make algorhymth of differential diagnostics taking into account the esophageal fibrovascular polyp in patients with dysphagia, vomiting, regurgitation and weight loss inspite of its rarity.