Fibrovascular polyp of the esophagus - diagnosis and therapy

Fibrovascular polyps are extremely rare benign neoplasms of the esophagus. The most prominent clinical symptom is enoral tumor regurgitation, which ma y lead to asphyxiation by pharyngeal impaction. Usually fibrovascular polyp s cause dysphagia and progressive weight loss. Diagnosis by endoscopy and b arium swallow may be unexpectedly difficult. The most frequent incorrect di agnoses are achalasia or an intramural or mediastinal tumorous mass compres sing the esophagus. CT scan and MR imaging are of little help. Small polyps may be resected endoscopically by means of electrocautery or Nd:YAG laser ablation. In most cases, however, surgical resection is required. Since the basis of the polyp is usually located subcricoidally, tumor exposure and r esection are achieved by esophagotomy via a left cervical approach. Thoraco tomy is seldom required.