Karagyozov P, Zhecheva I, Ivanov K, Galev I. Challenges in the diagnosis and treatment of giant fibrovascular polyps of the esophagus: Two case reports. World J Clin Cases 2026; 14(18): 121058 [DOI: 10.12998/wjcc.121058]
Corresponding Author of This Article
Petko Karagyozov, MD, PhD, Professor, Department of Gastroenterology, Acibadem City Clinic Tokuda University Hospital, Medical University of Pleven, 51Б bulevard Nikola Y. Vaptsarov, Sofia 1407, Bulgaria. petko.karagyozov@gmail.com
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Gastroenterology & Hepatology
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case-report
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Karagyozov P, Zhecheva I, Ivanov K, Galev I. Challenges in the diagnosis and treatment of giant fibrovascular polyps of the esophagus: Two case reports. World J Clin Cases 2026; 14(18): 121058 [DOI: 10.12998/wjcc.121058]
World J Clin Cases. Jun 26, 2026; 14(18): 121058 Published online Jun 26, 2026. doi: 10.12998/wjcc.121058
Challenges in the diagnosis and treatment of giant fibrovascular polyps of the esophagus: Two case reports
Petko Karagyozov, Ivelina Zhecheva, Kaloyan Ivanov, Ivan Galev
Petko Karagyozov, Ivelina Zhecheva, Kaloyan Ivanov, Clinic of Gastroenterology, Acibadem City Clinic University Hospital Tokuda, Sofia 1407, Bulgaria
Petko Karagyozov, Medical University, Pleven 5800, Bulgaria
Ivan Galev, Department of Clinical Patology, Acibadem City Clinic Tokuda University Hospital, Sofia 1407, Bulgaria
Co-corresponding authors: Petko Karagyozov and Ivelina Zhecheva.
Author contributions: Karagyozov P contributed to conceptualization and supervisio; Karagyozov P and Zhecheva I contributed to data curation and case management, investigation, writing-original draft, image acquisition and preparation, have played important and indispensable roles in the manuscript preparation as the co-corresponding authors; Ivanov K contributed to image acquisition; Galev I contributed to pathological analysis.
AI contribution statement: Only ChatGPT was used for grammar and language editing. No other artificial intelligence tools were employed. The entire content of the main text (abstract, introduction, materials and methods, results, discussion, and conclusion) or any part thereof was not generated by artificial intelligence. The entire scientific content of the manuscript was written by the author alone. All images were created by the author and no images generated by artificial intelligence were used.
Informed consent statement: Written informed consent was obtained from the patients for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors confirm that this case report has been prepared in accordance with the CARE guidelines (2016).
Corresponding author: Petko Karagyozov, MD, PhD, Professor, Department of Gastroenterology, Acibadem City Clinic Tokuda University Hospital, Medical University of Pleven, 51Б bulevard Nikola Y. Vaptsarov, Sofia 1407, Bulgaria. petko.karagyozov@gmail.com
Received: March 16, 2026 Revised: March 21, 2026 Accepted: May 20, 2026 Published online: June 26, 2026 Processing time: 93 Days and 4.2 Hours
Abstract
BACKGROUND
Fibrovascular polyps (FVPs) are rare benign pedunculated submucosal tumors of the esophagus that may reach considerable size and cause dysphagia or other compressive symptoms. The choice of treatment depends mainly on the size and location of the lesion and may include surgical or endoscopic resection.
CASE SUMMARY
We report two cases of esophageal FVPs treated by endoscopic submucosal dissection (ESD). The first patient presented with progressive dysphagia and significant weight loss. Endoscopy and computed tomography revealed a giant pedunculated esophageal mass. Complete en bloc resection was achieved endoscopically; however, extraction of the specimen was unsuccessful due to its large size. In the second patient, dysphagia led to the detection of a similar pedunculated lesion in the cervical esophagus. Endoscopic resection was successfully performed, and histopathological examination confirmed a FVPs.
CONCLUSION
FVPs are uncommon benign esophageal tumors. Although surgical resection has traditionally been the standard treatment, endoscopic techniques are increasingly preferred due to their minimally invasive nature and favorable recovery profile.
Core Tip: Esophageal fibrovascular polyps (FVPs) are uncommon benign tumors that often remain asymptomatic until they grow to a substantial size. When symptomatic, they may cause dysphagia, regurgitation, bleeding, or even life-threatening airway obstruction. We report two cases of esophageal FVPs successfully managed by endoscopic submucosal dissection. These cases demonstrate that, in selected patients, endoscopic treatment can be considered a safe and effective minimally invasive alternative to surgery.
