Pyogenic Granuloma of the Esophagus Treated by Endoscopic Removal

Okada, Nobuyuki; Matsumoto, T; Kurahara, Koichi; Kanamoto, K; Fukuda, Takashi; Okada, Yasuo; Iida, Minoru

doi:10.1055/s-2003-38159

Cited by 9 publications

(3 citation statements)

References 1 publication

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“…The size of the lesion can range from several millimeters to a few centimeters. It tends to be friable and hemorrhagic with occasional ulceration and white exudate noted on the surface of the lesion [2, 5, 6, 8, 9].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Mucosal Resection of a Proximal Esophageal Pyogenic Granuloma

Estifan

Patel

Grossman

2019

Case Reports in Gastrointestinal Medicine

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Pyogenic Granuloma (PG), also known as lobular capillary hemangioma, is usually seen as a polypoid red lesion found on the skin or the mucosal surface of the oral cavity. PG of the gastrointestinal tract is rare, in particular involving the esophagus, only 14 cases have been reported in the English literature. We present an 80-year-old male who underwent endoscopy for evaluation of dysphagia and was found to have a single, red, bilobed 10 mm polyp with adherent white exudate approximately 19 cm from the incisors. Endoscopic ultrasound was performed with a 20 mHz miniprobe which showed the lesion contained to the mucosal layer with no muscularis propria invasion. A decision was made to perform endoscopic mucosal resection (EMR). A mixture of saline and methylene blue was injected into the submucosal plane to raise the lesion with subsequent successful mucosal hot snare resection. The resection defect was then approximated and closed with a hemostatic clip to prevent bleeding. Pathology of the specimen revealed small capillary vessels growing in a lobular architecture with an edematous stroma and a florid inflammatory infiltrate representing a pyogenic granuloma. EMR allows for an en bloc resection of mucosal lesions with tumor-free margins, thereby providing both diagnostic and prognostic information. Comparing EMR with the novel technique of endoscopic submucosal dissection (ESD), the incidence of bleeding and perforation is much lower; making EMR the best and safest resection option for this rare hemangioma. In this case, we demonstrate that EMR is a safe technique in removing a pyogenic granuloma in the esophagus.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Mucosal Resection of a Proximal Esophageal Pyogenic Granuloma

Estifan

Patel

Grossman

2019

Case Reports in Gastrointestinal Medicine

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“…1,2 PG in the gastrointestinal tract is an extremely rare event, 2-5 and to the best of our knowledge, only 13 cases of PG in the esophagus have been previously described in the English literature (see Table 1). 2,3,6-15…”

Section: Discussionmentioning

confidence: 99%

Esophageal Pyogenic Granuloma: A Case Report and Review of the Literature

et al. 2018

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Pyogenic granuloma (PG) is a capillary hemangioma mainly found in the skin and oral mucosa, but rarely described in the esophagus. We report the case of a 66-year-old man who consulted for retrosternal pain. Endoscopic studies showed a 28-mm polypoid mass located at the distal esophageal mucosa. The patient underwent endoscopic resection, and the histopathological examination showed a neoplastic proliferation of small blood vessels growing in a lobular architecture, with edematous stroma and prominent inflammatory infiltrate. Special stains for fungus showed pseudohyphae compatible with Candida spp. Findings were consistent with those of an esophageal PG associated with Candida infection. This case is a reminder that PG can be found in the esophagus, can be associated with other entities such as Candida infection, and is one of the differential diagnoses of neoplastic vascular proliferations that may mimic malignancy. In addition, we reviewed previously reported cases of esophageal PG.

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“…Other treatment options include removing any etiological factors and performing surgical excision. It should be noted that incomplete excision, repeat injury of the area or the failure to remove causative irritants can result in local recurrence (12)(13)(14). Recurrent lesions sometimes emerge in deeper layers of the skin or mucosa (15).…”

Section: Discussionmentioning

confidence: 99%

Morphological Changes in a Pyogenic Granuloma of the Esophagus Observed over Three Years

et al. 2015

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A 78-year-old Japanese man underwent routine esophagogastroduodenoscopy, during which a reddish, flat elevated lesion was observed in the middle third of the esophagus. A bright red area of protrusion appeared in the center of the elevated lesion three months later, and the protruded nodule grew to be a blood blister six months after the initial endoscopy examination. The morphology of the lesion changed from a protruded nodule to a mass with two humps that subsequently returned to a single hump during the three-year observation period. A histological diagnosis of pyogenic granuloma was made based on a biopsy performed at six months. This report illustrates a rare case of an esophageal pyogenic granuloma presenting with a unique endoscopic appearance and morphologic changes. Endoscopic ultrasonography images are also presented.

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Pyogenic Granuloma of the Esophagus Treated by Endoscopic Removal

Cited by 9 publications

References 1 publication

Endoscopic Mucosal Resection of a Proximal Esophageal Pyogenic Granuloma

Endoscopic Mucosal Resection of a Proximal Esophageal Pyogenic Granuloma

Esophageal Pyogenic Granuloma: A Case Report and Review of the Literature

Morphological Changes in a Pyogenic Granuloma of the Esophagus Observed over Three Years

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