title: Unusual presentation of a giant benign inflammatory polyp in the upper esophagus.
abstract: BACKGROUND
  Benign inflammatory fibroid polyps (IFP) are rare submucosal tumors of the upper gastrointestinal tract. Rarely, they can develop in the esophagus, usually in the lower third. There are only 12 cases of giant IFP of the esophagus reported in literature and little is known about their origin, biological behavior and operative management. We present a patient with a giant benign IFP of the esophagus that originated from the upper esophagus.
  
  
  METHODS
  The patient is a 59-year-old male who presented with dysphagia. Upper endoscopy and esophagram revealed a giant intraluminal esophageal mass with a pedicle in the upper esophagus. Resection of this mass was performed through a left cervical esophagotomy. Pathology confirmed IFP, On 2 year follow up, there was no recurrence of the mass.
  
  
  CONCLUSIONS
  A giant IFP is defined as an IFP greater than 4cm, commonly present in the distal esophagus. Pathology usually reveals vascularized fibrous stroma with elements of inflammatory infiltrate. This mass is slow-growing and asymptomatic until it grows to a large size. Common diagnostic studies include barium esophagram, upper endoscopy, and CT imaging. A key pre-operative work-up is to identify the location of the pedicle to plan out surgical approach and to avoid injuring the rich blood supply thus preventing a life threatening hemorrhage during the operation.
  
  
  CONCLUSIONS
  Giant IFPs are infrequent in clinical practice. Resection is indicated and usually performed by a surgical intervention or endoscopic removal. The pathogenesis of these polyps remains poorly understood due to the rarity of these lesions.
authors.affiliation: University of Arizona Medical Center, Department of Surgery, Division of Cardiothoracic Surgery, USA. Electronic address: brawashdeh@surgery.arizona.edu.
authors.forename: Badi
authors.initials: B
authors.lastname: Rawashdeh
authors.affiliation: University of Arizona Medical Center, Department of Surgery, Division of Cardiothoracic Surgery, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Meyer
authors.affiliation: University of Arizona Medical Center, Department of Surgery, Division of Cardiothoracic Surgery, USA.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Gill
authors.affiliation: University of Arizona Medical Center, Department of Surgery, Division of Cardiothoracic Surgery, USA.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Moslemi
authors.affiliation: University of Arizona Medical Center, Department of Surgery, Division of Cardiothoracic Surgery, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kim
keywords: Esophagus; Giant polyps; Inflammatory fibroid polyps; Surgery