Case Report
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World J Gastroenterol. Sep 21, 2013; 19(35): 5936-5939
Published online Sep 21, 2013. doi: 10.3748/wjg.v19.i35.5936
Difficult polypectomy-giant hypopharyngeal polyp: Case report and literature review
Giovanni Pallabazzer, Stefano Santi, Solito Biagio, Simone D’Imporzano
Giovanni Pallabazzer, Stefano Santi, Solito Biagio, Simone D’Imporzano, Esophageal Surgery Unit, Tuscany Regional Referral Center for the Diagnosis and Treatment of Esophageal Disease, Medical University of Pisa, 56124 Pisa, Italy
Author contributions: Pallabazzer G performed the image diagnosis and wrote the paper; Santi S, Biagio S and D’Imporzano S performed the surgical operation.
Correspondence to: Giovanni Pallabazzer, MD, Esophageal Surgery Unit, Tuscany Regional Referral Center for the Diagnosis and Treatment of Esophageal Disease, Medical University of Pisa, Paradisa Str 2, 56124 Pisa, Italy. g.pallabazzer@ao-pisa.toscana.it
Telephone: +39-50-997824 Fax: +39-50-997809
Received: March 1, 2013
Revised: April 11, 2013
Accepted: May 18, 2013
Published online: September 21, 2013
Processing time: 203 Days and 9.3 Hours
Abstract

Giant esophageal and hypopharyngeal polyps are benign tumors rarely encountered in clinical practice. In most cases, they are completely asymptomatic; however, despite the rarity of these tumors, interest in giant esophageal polyps derives from their degree of growth (characterized by slow growth into the esophageal lumen) and their mobility. In fact, if regurgitation occurs, they can ascend into the oral cavity and be aspirated into the airways, with potentially lethal consequences. The removal of these giant polyps is recommended. An adequate preoperative evaluation to identify the correct origin of the stalk is mandatory for a successful endoscopic or surgical treatment. A 60-year-old man was admitted to our hospital for anemia. The patient underwent gastroscopy, contrast computed tomography and endoscopic ultrasound. At the conclusion of the procedure, during the extraction of the echoendoscope, the patient began retching and regurgitated the polyp, without experiencing respiratory distress. The patient underwent a left cervicotomy and polyp dissection via a pharyngotomy.

Keywords: Esophagus; Giant fibrovascular polyp; Esophageal polyp; Fibroepithelial polyps

Core tip: We report an unusual case of giant hypopharyngeal polyp in a patient with anemia by chronic oozing. Giant esophageal and hypopharyngeal polyps are benign tumors rarely encountered in clinical practice; in fact, there are approximately 250 cases reported in the literature. The interesting fact is the patient regurgitated the polyp during the extraction of the echoendoscope (photo), fortunately without experiencing respiratory distress. It is rare to diagnose these polyps and it is even rarer to perform emergency surgery due to the presence of a large, regurgitated polyp that occupies most of the oral cavity.