A 60-year-old man presented with progressive dysphagia to solids and liquids for 1 year. His dysphagia was associated with a 30-pound weight loss and intermittent melena. During this time his hemoglobin dropped by 2 g and his albumin to <2 g/dL. Barium esophagram revealed a large filling defect (Figure A). On esophagogastroduodenoscopy he was found to have a thick pedicle (20 cm in length) (Figure B) originating from the cervical esophagus with a (Figure C) large polypoid head (5 cm in diameter) with superficial ulceration, friability, granulation tissue, partially obstructing the gastroesophageal junction, and terminating in the proximal stomach. Superficial biopsies of the esophageal pedicle and polypoid head revealed squamous epithelium and granulation tissue respectively. Endoscopic ultrasound (Figure D) using a radial echoendoscope revealed a highly vascular esophageal

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