A rare case of giant fibrovascular polyp endoscopically resected with loop and cut technique.

Giant fibrovascular polyps (GFVPs) of the esophagus are a rare condition arising from the hypopharynx or from the cervical esophagus. They are generally benign, and malignant transformation is uncommon. The majority of GFVPs are diagnosed in men between 60 and 70 years of age and are larger than 5 cm.2, 3 The most common symptoms are dysphagia, respiratory symptoms, and regurgitation of polyps. More rare are bleeding, odynophagia, and cough.

An 88-year-old man with a history of coronary heart disease was referred to our endoscopic unit because of odynophagia and dysphagia for solid foods. EGD revealed a 10-cm peduncolated polyp (Fig. 1) arising from the hypopharynx and jutting into the esophagus. A CT scan confirmed the endoscopic finding.

Figure 1

EGD feature of the giant hypopharyngeal fibrovascular polyp.

Because of the patient’s symptoms, we decided to remove the polyp endoscopically. Resection of the polyp was performed with the patient under deep sedation with propofol, after an endoloop was positioned at the base of the peduncle (Fig. 2, Video 1, available online at www.VideoGIE.org). The resection, carried out with dual-knife (Fig. 3) and hook-knife (Fig. 4), was uneventful (Fig. 5). Food intake was started the next day.

Figure 2

Endoloop on the base of the hypopharyngeal fibrovascular polyp.

Figure 3

Resection with dual-knife at the base of the polyp.

Figure 4

Resection with the hook-knife at the base of the polyp.

Figure 5

Giant hypopharyngeal fibrovascular polyp after resection.

The patient was discharged 48 hours later. Histologic examination led to a diagnosis of giant fibrovascular polyp.

Disclosure

All authors disclosed no financial relationships relevant to this publication.