LIFE-THREATENING PRESENTATIONS OF FIBROVASCULAR ESOPHAGEAL AND HYPOPHARYNGEAL POLYPS

Giant fibrovascular polyps of the esophagus and hypopharynx are benign tumors of the upper digestive tract. Although a rare cause of asphyxi ation, laryngeal impaction by a regurgitated polyp of the esophagus ma y be the initial symptom that brings the patient to request medical at tention. Two new cases of giant fibrovascular polyps with dramatic and potentially life-threatening presentations illustrate the unpredictab le behavior of these unusual tumors. Both patients presented to the em ergency center with a history of coughing and eructation followed by t emporary airway obstruction that was relieved by clenching a regurgita ted fleshy mass between the teeth. Diagnostic and therapeutic interven tion requires aggressive airway management, radiographic and endoscopi c evaluation, and definitive surgical treatment. Tracheotomy was requi red in one patient, and successful endotracheal intubation provided sa tisfactory airway control in the second. Esophagoscopy revealed the or igin of both tumors to be near the cricopharyngeal muscle. Complete su rgical excision was curative in both cases.