Giant esophageal fibrovascular polyp with clinical behaviour of inflammatory pseudotumor: A case report and the literature review

Cuk, Vladimir; Knezevic-Usaj, Slavica; Ignjatović, Miroljub; Kostić, Zoran; Tarabar, Dino; Kovačević, Bojan; Šćepanović, Milena; Slavković, Damjan

doi:10.2298/vsp130219058c

Cited by 5 publications

(4 citation statements)

References 37 publications

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“…Most patients admitted to re‐swallow the polyp, and occasionally to capture it to convince a skeptical physician. Anemia was reported in 17 patients (9.6%) and was attributed to occult bleeding originating from the ulcerated tip of a long fibrovascular polyp (>15 cm) reaching the gastroesophageal junction and exposed to gastroesophageal reflux [12, 24, 35, 43, 58]. Physical examination was unremarkable in most patients, except those presenting with acute transoral polyp regurgitation ( n = 3) (Table 2).…”

Section: Resultsmentioning

confidence: 99%

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Esophageal Lipoma and Liposarcoma: A Systematic Review

et al. 2020

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Background Esophageal lipomatous tumors, also reported as fibrovascular polyp, fibrolipoma, angiolipoma, and liposarcoma, account for less than 1% of all benign mesenchymal submucosal tumors of the esophagus. Clinical presentation and therapy may differ based on location, size, and morphology. A comprehensive and updated systematic review of the literature is lacking. Methods A systematic review of the literature was performed according to PRISMA guidelines. Pubmed, Embase, Cochrane, and Medline databases were consulted using MESH keywords. Non-English written articles and abstracts were excluded. Sex, age, symptoms at presentation, diagnosis, tumor location and size, surgical approach and technique of excision, pathology, and morphology were extracted and recorded in an electronic database. Results Sixty-seven studies for a total of 239 patients with esophageal lipoma or liposarcoma were included in the qualitative analysis. Among 176 patients with benign lipoma, the median age was 55. The main symptoms were dysphagia (64.2%), transoral polyp regurgitation (32.4%), and globus sensation (22.7%). The majority of lipomas (85.7%) were intraluminal polyps, with a stalk originating from the upper esophagus. Overall, 165 patients underwent excision of the mass through open surgery (65.5%), endoscopy (27.9%), or laparoscopy/thoracoscopy (3.6%). Only 5 (3%) of patients required esophagectomy. Of the 11 untreated patients with an intraluminal polyp, 7 died from asphyxia. Overall, liposarcoma was diagnosed in 63 patients, and 12 (19%) underwent esophagectomy. Conclusion Esophageal lipomatous tumors are rare but potentially lethal when are intraluminal and originate from the cervical esophagus. Modern radiological imaging has improved diagnostic accuracy. Minimally invasive transoral and laparoscopic/thoracoscopic techniques represent the therapeutic approach of choice.

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Section: Resultsmentioning

confidence: 99%

“…Sixty‐five case reports, [1, 2, 5, 6, 8, 10, 12, 13, 17–73] and two reviews [11, 74], published between 1955 and May 2020, were included in the systematic review. The total number of patients was 239, including 176 with lipoma and 63 with liposarcoma.…”

Section: Resultsmentioning

confidence: 99%

Esophageal Lipoma and Liposarcoma: A Systematic Review

et al. 2020

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“…1,9 Clinical presentation may be nonspecific and varied because the tumor grows very slowly; nonetheless, dysphagia, regurgitation, and weight loss are among the most common symptoms. 10 Upper gastrointestinal bleeding, chest or abdominal pain, fever, and anemia, although rarer, have also been described in several case reports. 11–14 In our case, the patient experienced episodes of respiratory symptoms, dysphagia, and finally an episode of severe asphyxia.…”

Section: Discussionmentioning

confidence: 96%

Asphyxia Caused by a Giant Fibrovascular Polyp of the Esophagus

et al. 2019

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Fibrovascular polyps (FVPs) are rare, benign tumors of the esophagus; they usually appear as an intraluminal mass within the esophagus, which can grow and reach enormous sizes if left untreated. They can cause a variety of symptoms, from mild dysphagia to life-threatening asphyxia. Diagnosis is challenging because FVPs can resemble any respiratory condition, which can lead to misdiagnosis and potentially dangerous therapies. We present a 47-year-old man who suffered from recurrent episodes of odynophagia. This time he suffered an incident of severe asphyxia and loss of consciousness. After complementary examinations, an FVP was detected and successfully treated.

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“…Another diagnostic hurdle in this case was that the intense FDG-avid ulcer in the mass mimicked malignancy. Although there are some reports about FVPs, [3][4][5] FVPs showing intense FDG uptake are extremely rare. In a previous report, an FVP with concurrent liposarcoma had an SUV max of 4.7.…”

Section: Figurementioning

confidence: 99%

Giant Fibrovascular Polyp Mimicking Esophageal Malignancy on 18F-FDG PET/CT

Kim,

Chae,

Kim

et al. 2023

Clin Nucl Med

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A 52-year-old man presented with continuous dull pain from the throat to the epigastric region with dysphagia. Initial endoscopy misdiagnosed a subepithelial tumor causing external compression of the esophagus. A CT scan visualized a 14.0 × 4.0-cm pedunculated mass inside the esophagus. Subsequent 18F-FDG PET/CT identified an intense FDG-avid area in the mass, which strongly suggested esophageal cancer. Total mass excision was performed, and fibrovascular polyp with chronic ulcerative inflammation was finally confirmed on histologic examination.

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Giant esophageal fibrovascular polyp with clinical behaviour of inflammatory pseudotumor: A case report and the literature review

Abstract: We reported a patient with giant esophageal pedunculated tumor with clinical manifestations of inflammatory pseudotumor and histopathological picture of fibrovascular polyp, that we have not found described in the literature before.

Cited by 5 publications

References 37 publications

Esophageal Lipoma and Liposarcoma: A Systematic Review

Esophageal Lipoma and Liposarcoma: A Systematic Review

Asphyxia Caused by a Giant Fibrovascular Polyp of the Esophagus

Giant Fibrovascular Polyp Mimicking Esophageal Malignancy on 18F-FDG PET/CT

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