Presentation and Management of Giant Fibrovascular Polyps of the Hypopharynx and Esophagus

Ann Otol Rhinol Laryngol. 2017 Jan;126(1):29-35. doi: 10.1177/0003489416672872. Epub 2016 Oct 7.

Abstract

Objective: Fibrovascular polyps of the hypopharynx and esophagus are rare, with few case reports in the literature. In this article, we present our institutional experience with a focus on airway and surgical management.

Study design: Case series.

Setting: Tertiary academic institution.

Methods: A retrospective review was conducted of 4 patients that presented to a tertiary medical center with fibrovascular polyps between 1990 and 2012. Patient demographics, clinical presentation, diagnostic studies, and surgical approaches were reviewed. A review of the published literature was also performed.

Results: The average age at presentation was 72 years (range, 59-85 years). Among the 4 patients, 2 presented with airway compromise requiring tracheotomy. All patients had removal of the polyp shortly after presentation; 2 underwent transcervical approaches with lateral pharyngotomy/esophagotomy, and the other 2 had endoscopic removal. The polyps arose from the hypopharynx in 3 patients and upper esophagus in 1. Three patients had complete resolution of their symptoms and remained disease free. One patient had recurrence of the polyp 2 years later and is currently being observed.

Conclusion: Fibrovascular polyps are rare tumors of the hypopharynx/esophagus that present in older adults. Although benign, they can cause life-threatening airway compromise that may necessitate tracheotomy. We present 4 cases of fibrovascular polyps and discuss our evolving surgical management, including endoscopic removal.

Keywords: endoscopic; esophagus; fibrovascular; hypopharynx; polyp.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Airway Obstruction / etiology
  • Airway Obstruction / surgery
  • Endoscopy
  • Esophageal Diseases / complications
  • Esophageal Diseases / surgery*
  • Female
  • Humans
  • Hypopharynx / surgery*
  • Male
  • Middle Aged
  • Pharyngeal Diseases / complications
  • Pharyngeal Diseases / surgery*
  • Polyps / complications
  • Polyps / surgery*
  • Respiratory Distress Syndrome, Adult / etiology
  • Respiratory Distress Syndrome, Adult / surgery
  • Retrospective Studies