Giant fibrovascular polyp of the esophagus.
Giant fibrovascular polyps are uncommon benign esophageal tumors almost always originating from the cervical esophagus, frequently from the upper esophageal sphincter. The case of a 74-year-old man with a long history of dysphagia and a weight loss of 9 kg is presented. Neither barium esophagogram, computed tomogram or magnetic resonance imaging correctly evidenced the lesion. Only fiberoptic endoscopy suggested the correct diagnosis because the mass fluctuated endoluminally with the spasm of vomiting. A left cervical exploratory incision with esophagotomy was performed following the experience of two previous similar cases. A giant fibrovascular polyp was observed and excised. If a malignant or benign extensive intramural tumor had been identified, a total esophagectomy would have been performed. In our opinion the possibility of the presence of a fibrovascular polyp should always be considered in the presence of an undetermined esophageal mass, and in these cases a left cervical incision is the preferred surgical access. Once the correct diagnosis is established, a major esophageal resection should always be avoided.
Solerio
D
D
Division of General Surgery 3, San Giovanni Battista Hospital, Univerrsity of Turin, Italy. soleriod@libero.it
Gasparri
G
G
Ruffini
E
E
Camandona
M
M
De Angelis
C
C
Raggio
E
E
Dei Poli
M
M
D000368:Aged; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D004946:Esophagostomy; D006801:Humans; D008297:Male; D011127:Polyps / Q000175:diagnosis* / Q000601:surgery