Unusual presentation of a giant benign inflammatory polyp in the upper esophagus

Letter to the editor: esophageal inflammatory fibroid polyp in a Nigerian

NIL.

Laparoscopy Endoscopy Cooperative Surgery for Inflammatory Fibroid Polyp in the Esophagus

Inflammatory fibroid polyp (IFP) appears most often in the stomach. We herein report an extremely rare case of esophageal IFP resected using laparoscopy endoscopy cooperative surgery (LECS). A 73-year-old man with dysphagia underwent esophagogastroduodenoscopy. A 50-mm semi-pedunculated submucosal tumor was observed in the esophagogastric junction. Endoscopic ultrasonography showed a homogeneous, hypoechoic, and well-vascularized tumor in the second and third layers of the stomach, but endoscopic ultrasonography-guided fine-needle aspiration failed to establish a definite diagnosis. Since he was suffering from dysphagia, LECS was performed. The resected specimen proved that the tumor was an IFP originating from the esophagus.

An unusual case report of inflammatory fibrous polyps in the upper gastrointestinal tract

Inflammatory fibrous polyps (IFPs) were considered to be benign and umcommon, which can seriously affect the quality of life. We reported a case with the IFP presented with atypical symptoms and the so-called "ball valve syndrome". The final diagnosis is ultimately made after surgery. At 18 months of follow-up, the case remained symptom-free. It is worth mentioning, the definitive diagnosis of IFPs is always difficult to reach, which should be clinical, radiologic, endoscopic, histological, and immunohistochemical, although abdominal imageology, gastrointestinal endoscopy and endoscopic ultrasonography(EUS) may provide some important clues of the disease. Although therapy options usually include endoscopic mucosal resection and surgical excision, the preferred method was mainly depending on the size, location, biological property of the lesion and clinical presentations.

Inflammatory fibroid polyp of the gastrointestinal tract: 10 years of experience at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

BACKGROUND

Inflammatory fibroid polyp (lFP) is a rare, benign, and solitary neoplasm predominantly located in the gastric antrum and small bowel. Its clinical symptoms are heterogeneous and essentially depend on the location and size of the tumor. Definitive diagnosis is made through histopathology and this pathology has excellent long-term prognosis.

AIM

To identify the cases of IFP seen at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán over a 10-year period.

METHODS

A retrospective, cross-sectional, descriptive, and observational study was conducted that included patients with histopathologic diagnosis of IFP within the time frame of January 2001 and December 2011.

RESULTS

Six cases were found and 5/6 (83.3%) of them were women. The median age was 41 years (minimum-maximum range of 19-56 years). The most frequent symptoms were weight loss (n=3), fever (n=2), nausea (n=2), and vomiting (n=2). Three patients presented with iron deficiency anemia and 2 cases with intussusception. The IFPs were located at the following sites: esophagus (n=1), stomach (n=2), small bowel (n=2), and colon (n=1). Treatment was surgical in 5/6 (83.3%) of the patients.

CONCLUSIONS

IFPs are extremely rare in our population. They usually present with weight loss and iron deficiency anemia and are more frequently located in the stomach and small bowel. This is the largest reported IFP case series in a Mexican population.

Unusual Causes of Upper Gastrointestinal Bleeding

Upper gastrointestinal (GI) bleeding is an important clinical condition managed routinely by endoscopists. Diagnostic and therapeutic options vary immensely based on the source of bleeding and it is important for the gastroenterologist to be cognizant of both common and uncommon etiologies. The focus of this article is to highlight and discuss unusual sources of upper GI bleeding, with a particular emphasis on both the clinical and endoscopic features to help diagnose and treat these atypical causes of bleeding.