A rare case of giant fibrovascular polyp endoscopically resected with loop and cut technique

A rare case of giant fibrovascular polyp endoscopically resected with loop and cut technique Accepted Manuscript A rare case of giant fibrovascular polyp endoscopically resected with loop and cut tech[.]

A rare case of giant fibrovascular polyp endoscopically resected with loop and cut

technique

Benedetto Mangiavillano, Maria Flavia Savarese, Federica Boeri, Corrado Ruggeri,

Massimo Conio

PII: S2468-4481(16)30095-9

DOI: 10.1016/j.vgie.2016.12.006

Reference: VGIE 56

To appear in: VideoGIE

Received Date: 31 October 2016

Revised Date: 14 December 2016

Accepted Date: 16 December 2016

Please cite this article as: Mangiavillano B, Savarese MF, Boeri F, Ruggeri C, Conio M, A rare case of

giant fibrovascular polyp endoscopically resected with loop and cut technique, VideoGIE (2017), doi:

10.1016/j.vgie.2016.12.006

This is a PDF file of an unedited manuscript that has been accepted for publication As a service to our customers we are providing this early version of the manuscript The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain

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A rare case of giant fibrovascular polyp endoscopically resected with loop and cut

technique

Benedetto Mangiavillano°, Maria Flavia Savarese*, Federica Boeri*, Corrado Ruggeri#,

Massimo Conio*

°GastrointestinalEndoscopy Unit – Humanitas Mater Domini – Castellanza (VA)

*Gastroenterology & Gastrointestinal Endoscopy, General Hospital – Sanremo – Italy

#Department of Pathology, General Hospital – Sanremo – Italy

Corresponding Author:

Benedetto Mangiavillano, MD

Gastrointestinal Endoscopy Unit

Humanitas - Mater Domini

Via Gerenzano n.2, 21053– Castellanza (VA)

tel: 0039 0331 476205 - 381

mail: b_mangiavillano@hotmail.com

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Giant fibrovascular polyps (GFVP) of the esophagus are a rare condition arising from the hypopharynx or from the cervical esophagus The GFVPs are generally benign, and the malignant transformation is uncommon (1) The majority of the GFVPs are diagnosed in men between 60 and 70 years of age and are more than 5 cm (2,3) The most common symptoms are dysphagia, respiratory symptoms and polyp’s regurgitation (4) More rare is bleeding, odynophagia, and cough (5)

An 88-year-old man with a history of coronary heart disease was referred to our endoscopic unit because of odynophagia and dysphagia for solid foods An esophagogastroduodenoscopy (EGDS) revealed a 10-cm peduncolated polyp (Fig 1), arising from the hypopharynx, jutting into the esophagus The CT scan confirmed the endoscopic finding

Because of the patient’s symptoms, we decided to remove the polyp endoscopically Resection of the polyp was performed with the patient under deep sedation with propofol, after positioning an endoloop on the basis of the peduncle (video) The resection, carried out with dual-knife and hook-knife, was uneventful Food intake was started the day after

The patient was discharged 48 hours later Histology diagnosed a giant fibrovascular polyp

Legends

Figure 1: EGD feature of the giant hypopharyngeal fibrovascular polyp

Figure 2: Endoloop on the basis of the hypopharyngeal fibrovascular polyp

Figure 3: Resection with the dual-knife of the basis polyp

Figure 4: Resection with the hook-knife of the basis polyp

Figure 5: Giant hypopharyngeal fibrovascular polyp after resection

Video: Video showing the resection of the giant fibrovascular polyp

References

1

Sargent RL, Hood IC, Asphixiation caused by giant fibrovascular polyp of the esophagus Arch Pathol Lab Med 2006;130:725-7

2

I H, Kim JS, Shim YM Giant fibrovascular polyp of the hypopharynx: surgical treatment with the biappoach J Korean Med Sci 2006;21:749-51

3

Lee SY, Chan WH, Sivanandan R, Lin DT, Won WK Recurrent giant fibrovascular polyp of the esophagus World J Gastroenterol 2009;15:3697-700

4

Fries MR, Galindo RL, Flint PW, Abrahm SC Giant fibrovascular polyp of the esophagus A lesion causing upper airway obstruction and syncope Arch pathol Lab Med 2003; 127:485-7

5

Schuhmacher C, Becker K, Dittler HJ, Hofler H, Siewert JR, Stein HJ Fibrovascular esophageal polyp as a diagnostic challenge Dis Esophagus 200;13:324-7

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