術前診断が困難であった食道の巨大なｆｉｂｒｏｖａｓｃｕｌａｒ　ｐｏｌｙｐの１切除例

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  • A Case of Benign Giant Fibrovascular Polyp of the Upper Esophagus Contrary to Pre-Operative Diagnosis.

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A 43-year-old man was admitted to our hospital following 5kg weight loss and 3 weeks of dysphagia. An X-ray examination showed a giant, nodular and elevated tumor measuring 15 cm in length in the upper esophagus. An endoscopy identified a large submucosal tumor with an ulceration at the distal end. An endoscopic biopsy from the ulcerated area showed no malignancy. Carcinosarcoma, however, was suspected because of an extraordinary size of the tumor and also of the ulcer formation. The lesion, therefore, was surgically removed by means of a total thoracic esophagectomy. As a result, the tumor proved to be, histologically, a fibrovascular polyp contrary to our pre-operative diagnosis. A fibrovascular polyp is relatively rare in an esophagus. So far, only abot 70 cases have been reported in the world including 26 in Japan. Only two fibrovascular polyps measuring more than 10cm each have been reported in Japan. Various aspects of our case are described in detail in this report with the reasons for the misdiagnosis. Appropriate therapeutic approach are also discussed.

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