A Case of Esophageal Fibrovascular Polyp That Induced Asphyxia during Sleep

Abstract

Esophageal fibrovascular polyps are rare, benign, submucosal tumors of the upper digestive tract that usually have an indolent course until the lesion attains a very large size. The most frequent complaints associated with these tumors include dysphagia and foreign body sensation. However, a long pedunculated polyp can regurgitate into the pharynx or oral cavity and cause asphyxia and sudden death if the larynx is occluded. We describe the case of a 51-year-old man who experienced snoring and occasional asphyxia during sleep. Upper endoscopy was performed, which indicated the presence of a pedunculated esophageal polyp that regurgitated into the vocal cords. The polyp was removed using a polypectomy snare and was confirmed to be a fibrovascular polyp based on pathologic examination findings. Three months after the excision of the polyp, the patient was found to be doing well without any further occurrence of asphyxia or sleep disturbances.

Keywords: Asphyxia; Esophagus; Polyps; Snoring.

Fig. 1

Endoscopic and gross images of a fibrovascular polyp of the esophagus. (A) Elongated polyp originating from the cervical esophagus. (B) Regurgitating polyp aspirated into the vocal cords. (C) Regurgitated polyp obstructing the airway. (D) Resected esophageal polyp measuring greater than 5 cm in length.

Fig. 2

Histopathological features of the fibrovascular polyp. The core of the polyp is composed of dilated blood vessels and fibrous connective tissue covered by squamous epithelium with acanthosis (H&E stain, ×40).