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Yang L, Zhao R, Lu D, Zhang Y, Hu A, Huang S. Giant Fibrovascular Polyp of Hypopharynx: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2023:1455613221148311. [PMID: 36625500 DOI: 10.1177/01455613221148311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Fibrovascular polyps (FVPs) are rare benign submucosal tumor-like lesions originating in the cervical esophagus and sporadically in the hypopharynx. In this article, we report a rare case of FVPs of the hypopharynx (hFVPs) with a mass measuring 16.0 × 4.0 × 1.8 cm in size, discussed its surgical strategy, and additionally reviewed relevant literature on important factors, such as age, sex, symptoms, size, treatments, and recurrence, associated with hFVPs.
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Affiliation(s)
- Liyun Yang
- Department of Otolaryngology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Runyu Zhao
- Postgraduate Training Base at Shanghai Gongli Hospital, Ningxia Medical University, Shanghai, China
| | - Dan Lu
- Department of Otolaryngology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Yi Zhang
- Department of Otolaryngology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - An Hu
- Department of Otolaryngology, Gongli Hospital, The Second Military Medical University, Shanghai, China
| | - Shuixian Huang
- Department of Otolaryngology, Gongli Hospital, The Second Military Medical University, Shanghai, China
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2
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Marini K, Garefis K, Skliris JP, Astreinidou A, Kousoulis P, Florou V. Fibrovascular Polyp of the Tongue. EAR, NOSE & THROAT JOURNAL 2022:1455613221088704. [PMID: 35417286 DOI: 10.1177/01455613221088704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Katerina Marini
- Department of ORL, Head and Neck Surgery, 69204"G. Gennimatas" General Hospital, Thessaloniki, Greece
| | - Konstantinos Garefis
- 2nd Academic ORL, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - James Philip Skliris
- Department of Pathology, "37798G. Papanikolaou" General Hospital, Thessaloniki, Greece
| | - Anna Astreinidou
- Department of ORL, Head and Neck Surgery, 69204"G. Gennimatas" General Hospital, Thessaloniki, Greece
| | | | - Vasiliki Florou
- Department of ORL, Head and Neck Surgery, 69204"G. Gennimatas" General Hospital, Thessaloniki, Greece
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Li WX, Bai JQ, Dong YB, Liu LF. Diagnosis and Management of Giant Esophageal Fibrovascular Polyp With Hypopharyngeal Pedicle. EAR, NOSE & THROAT JOURNAL 2021; 101:374-378. [PMID: 34842469 DOI: 10.1177/01455613211046461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Fibrovascular polyps (FVPs) with hypopharyngeal pedicles (hFVPs) are the rare intraluminal benign tumours of the upper aerodigestive tract, and their accurate diagnosis and optimal management are challenging. Purpose: The present retrospective study attempted to explore the optimal diagnosis and treatment of hFVPs. Research Design: The clinical records of 2 patients with giant, irregularly shaped hFVPs, who underwent several failed surgical procedures after inaccurate diagnosis, were reviewed. Finally, the patients were correctly diagnosed and successfully treated at Capital Medical University Beijing Friendship Hospital in different years, 2018 and 2020. Results: Case 1 was of a 43-year-old woman with 2 months of progressive dysphagia. Gastroenterologists overlooked the origin of her FVP, and decided to sever its narrowest point in the oesophagus through endoscopy. However, upon unsuccessful removal of the mass, a gastrotomy procedure was performed to extract the mass 7 days later. Symptoms recurred 3 months after the treatment, and a fibreoptic laryngoscopy confirmed hFVP in the patient at our department. A transcervical approach was used to sever the hypopharyngeal pedicle, achieve haemostasis and remove the oesophageal tumour. No recurrence was detected during the 2-year follow-up period after the treatment. Case 2 was of a 32-year-old man with dysphagia who had previously undergone transthoracic and transcervical oesophagotomy procedures within a gap of 3 months for the removal of FVP causing dysphagia. The hypopharyngeal pedicle was not diagnosed in the patient. The symptoms of dysphagia recurred 4 years after the treatment, and a fibreoptic laryngoscope confirmed hFVP at our department. The tumour was removed successfully through the transcervical approach. No recurrence was detected during the 6-months follow-up after surgery. Conclusion: In conclusion, the transcervical approach is suitable for achieving haemostasis and removing giant, irregularly shaped hFVPs.
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Affiliation(s)
- Wan-Xin Li
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, China
| | - Jia-Qi Bai
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, China
| | - Yan-Bo Dong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, China
| | - Liang-Fa Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, China
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Oka M, Ueha R, Nito T, Yamasoba T. Giant fibrovascular polyp in the hypopharynx: a case report and review of the literature. SPRINGERPLUS 2016; 5:1443. [PMID: 27652019 PMCID: PMC5005220 DOI: 10.1186/s40064-016-3144-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/24/2016] [Indexed: 11/24/2022]
Abstract
Introduction Fibrovascular polyps (FVPs) are benign tumors that commonly occur in the cervical esophagus. Few cases of FVPs of the hypopharynx have been reported, but there has been no English review concerning hypopharyngeal FVPs (hFVPs). Here, we report a case of a vast hFVP, and we also review 13 hFVP cases found in the English literature (PubMed search) including our case. Case description A 41-year-old man with respiratory distress and regurgitation of a mass was referred to our hospital. Endoscopic and radiographic evaluations were required for diagnosis. The tumor originated from the hypopharynx and covered almost the entire larynx, which caused the airway to narrow. An emergency surgical removal was performed under general anesthesia with orotracheal intubation, and the tumor was completely removed transorally using a laryngeal endoscope. Pathological examination revealed that the mass was a FVP. Discussion and Evaluation We investigated patient characteristics, symptoms, polyp size, treatments, and recurrence of 13 hFVP cases. Regurgitation of a mass, dyspnea, and dysphagia were frequently reported symptoms at presentation. All patients were treated by surgical excision with no recurrence. Airway management is critical and tracheotomies were needed in some cases. Conclusions FVPs are often asymptomatic, and they can suddenly cause respiratory distress from laryngeal blockage. Therefore, we emphasize that when such cases are encountered, airway management and surgical treatment should be considered as early as possible.
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Affiliation(s)
- Mineko Oka
- Department of Otolaryngology Head and Neck Surgery, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8524 Japan
| | - Rumi Ueha
- Department of Otolaryngology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Takaharu Nito
- Department of Otolaryngology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
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Giant fibrovascular polyp on aryepiglottic fold. Auris Nasus Larynx 2015; 43:212-5. [PMID: 26299198 DOI: 10.1016/j.anl.2015.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 07/20/2015] [Accepted: 08/03/2015] [Indexed: 11/23/2022]
Abstract
Polyps are common lesions in pharynx and larynx. A 46-year-old woman was transferred to our department because of the huge laryngeal mass, which was incidentally detected during routine health screening. On laryngoscopic exam, both vocal folds were not visualized due to the mass but she had no symptom such as hoarseness, dysphagia, and dyspnea. Awake intubation was safely performed using flexible bronchoscope without tracheostomy. A 4-cm sized mass on the left aryepiglottic fold was removed with trans-oral approach and discharged without complication. The pathologic diagnosis was reported as 'fibrovascular polyp'. Herein, we describe a unique case of giant fibrovascular polyp on aryepiglottic fold, which is the first report in the English literature.
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Pajor A, Maciaszczyk K, Wągrowska-Danilewicz M, Pazurek M, Murlewska A. [Rare case of giant fibrovascular polyp of the esophagus]. Otolaryngol Pol 2013; 67:176-9. [PMID: 23719276 DOI: 10.1016/j.otpol.2012.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2011] [Accepted: 12/05/2011] [Indexed: 11/20/2022]
Abstract
The benign lesions of esophagus constitutes small part of all esophageal tumors and among them giant esophageal polyps are exceptionally rarely reported. The authors present the uncommon case of pedunculated giant fibrovascular polyp (lenght 12cm and diameter 2cm) in the esophagus in a 79-years-old woman who was admitted to our department because of hoarseness, throat discomfort during swallowing and endoral tumor regurgitation during cough. The polyp was removed by minimally invasive approach by endoscopic procedure which was particularly important in our patient because of her advanced age. No recurrence was observed during follow-up.
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Affiliation(s)
- Anna Pajor
- I Katedra Otolaryngologii Uniwersytetu Medycznego w Łodzi, Uniwersytecki Szpital Kliniczny nr 1 im. N. Barlickiego, Poland.
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Lee EJ, Hong SG, Baek HR, Lee CB, Choi SM, Kim SJ, Chae BG, Choi CY. A case of large fibrovascular polyp of the stomach. Clin Endosc 2013; 46:186-8. [PMID: 23614131 PMCID: PMC3630315 DOI: 10.5946/ce.2013.46.2.186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 05/30/2012] [Accepted: 06/20/2012] [Indexed: 01/19/2023] Open
Abstract
A fibrovascular polyp is a rare benign disease of the upper digestive tract and is usually located in the esophagus. To our knowledge, this is the first case of gastric fibrovascular polyp presenting with melena reported in the English literature. The polyp was well visualized on endoscopy and removed with laparoscopic wedge resection. Histology confirmed fibrovascular polyp of the stomach.
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Affiliation(s)
- Eun Ji Lee
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
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Dali H, Barry B, Wassef M, Mansouri D, Hourseau M, Hénin D, Soufan R. [Pharyngeal fibrovascular polyp]. Ann Pathol 2011; 31:211-3. [PMID: 21737004 DOI: 10.1016/j.annpat.2011.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 12/08/2010] [Accepted: 02/09/2011] [Indexed: 12/14/2022]
Abstract
The giant fibrovascular polyp of the hypopharynx is a rare and benign tumor. We report one case in a 46-year-old man. This lesion, usually unique, affects predominantly men with an average age of 53 years. These polyps are located predominantly in the upper esophagus and rarely in the hypopharynx. They are usually asymptomatic and small, detected by endoscopy. They can grow to considerable length and cause digestive or respiratory symptoms. Histologically, fibrovascular polyps consist of a various mixture of fibrous and lipomatous elements with abundant vascularisation and they are covered by normal squamous epithelium. The lack of muscular support and the pressure difference in the peristaltic wave contribute to polyp formation.
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Affiliation(s)
- Hayet Dali
- Service d'anatomie et de cytologie pathologiques, université Paris 7, hôpital Bichat Claude-Bernard, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France.
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Giant fibrovascular polyp of the hypopharynx: per-oral endoscopic removal. The Journal of Laryngology & Otology 2011; 125:1087-90. [PMID: 21729452 DOI: 10.1017/s0022215111001034] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We report an extremely rare case of giant fibrovascular polyp of the hypopharynx. METHOD We present a 49-year-old man who had increasing difficulty swallowing, advanced respiratory distress and weight loss, as well as a hypopharyngeal mass protruding from his mouth. RESULTS Diagnosis was confirmed by endoscopic examination and computed tomography. A tracheostomy was required due to laryngeal obstruction by the regurgitated mass. The giant polyp was removed via per-oral endoscopic excision under general anaesthesia. CONCLUSION Fibrovascular polyps occur most commonly in the cervical oesophagus, and are extremely rare in the hypopharynx. They can grow to a very large size over several years. We discuss the symptoms, diagnosis and surgical treatment techniques for upper aerodigestive tract fibrovascular polyps, in the light of the literature.
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Goenka AH, Sharma S, Ramachandran V, Chattopadhyay TK, Ray R. Giant fibrovascular polyp of the esophagus: report of a case. Surg Today 2010; 41:120-4. [PMID: 21191703 DOI: 10.1007/s00595-009-4212-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Accepted: 10/20/2009] [Indexed: 11/25/2022]
Abstract
A fibrovascular polyp is a peculiar nonepithelial tumor of the esophagus that invariably arises in the cervical esophagus at the level of the thoracic inlet and grows distally into a massive elongated, pedunculated, intraluminal lesion. Although it is a benign lesion that is eminently resectable, it is a dramatic entity owing to its tendency to cause bizarre complications such as asphyxia and sudden death when it regurgitates into the pharynx and causes laryngeal impaction. This report describes the multimodality imaging appearance of an archetypal case of a giant fibrovascular polyp in a patient with a seemingly innocuous presentation for the size of the lesion. The essential role of cross-sectional imaging in establishing a prompt diagnosis, defining the tissue elements of the mass, and delineation of the exact extent of the lesion in guiding the treatment approach is highlighted. The appearance of fibrovascular polyp in a single patient with a combination of barium swallow, multidetector computed tomography, and high-resolution contrast-enhanced magnetic resonance imaging has not been reported previously.
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Affiliation(s)
- Ajit Harishkumar Goenka
- Department of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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Abstract
The so-called "giant fibrovascular polyps" of the esophagus and hypopharynx typically present as sausage-like pedunculated structures that protrude into the lumen and cause obstructive symptoms. Most are cured by local resection but they may recur. Microscopically, they display an admixture of fibrovascular and adipose tissue that is coated by unremarkable squamous mucosa. Here, we report a case that had scattered hyperchromatic cells and lipoblasts within the adipose tissue component. In other anatomic sites similar appearing lesions have been interpreted as pedunculated liposarcomas/atypical lipomatous tumors that are more prone to local recurrences than classic giant fibrovascular polyps. Reports of dedifferentiation and metastases are lacking thus raising the possibility that the cytologic findings in such lesions are degenerative. To confirm our suspicion of liposarcomatous differentiation, we performed immunohistochemistry for MDM2 and p53, 2 markers that are known to be negative in benign lipomatous lesions and positive in well-differentiated liposarcomas/atypical lipomatous tumors. The scattered atypical hyperchromatic cells and the lipoblasts both exhibited strong nuclear staining for both markers and supported the diagnosis of pedunculated giant hypopharyngeal atypical lipomatous tumor.
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Abstract
Fibrovascular polyps of the esophagus and hypopharynx are benign tumors of the upper digestive tract. The majority of these polyps are located in the upper part of the esophagus but the hypopharyngeal fibrovascular polyps are only rarely seen. Most of them are surgically treated and this is usually done through a cervical incision, although some of them have been removed endoscopically. The authors report here on a case of a 63-yr-old-man with a giant fibrovascular polyp of the hypopharynx that extended into the stomach; this polyp was removed through simultaneous transcervical and transabdominal approaches because of the huge size of the polyp. The man presented with progressive dysphagia of 1 yr duration. The preoperative assessment revealed a giant polyp arising from the left arytenoid and extending into the stomach. The dimension of the polyp was about 26 x 10 x 4 cm. The complete resection of the polyp with the simultaneous transcervical and transabdominal approaches was successful, and it was diagnosed as a fibrovascular polyp. The patient has been followed up without any recurrence for 6 month postoperatively.
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Affiliation(s)
- Hoseok I
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Jin Sun Kim
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Young Mog Shim
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
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Ridge C, Geoghegan T, Govender P, McDermontt R, Torreggiani W. Giant oesophageal fibrovascular polyp (2005:12b). Eur Radiol 2006; 16:764-6. [PMID: 16470418 DOI: 10.1007/s00330-005-0112-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2005] [Accepted: 08/09/2005] [Indexed: 11/30/2022]
Abstract
The authors report a case of a giant fibrovascular polyp of the oesophagus in which CT with multiplanar reformatting gave valuable information as to both location of the lesion as well as size and anatomical attachment proximally, which was pivotal in directing surgery. It was instructive in this case that initial endoscopy was reported to be normal. The lesion was well demonstrated by barium swallow.
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Affiliation(s)
- Carole Ridge
- Department of Radiology, AMNCH, Tallght Hospital, Dublin, 24, Ireland.
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