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A case report of a midesophageal diverticulum mimicking a fibrovascular esophageal polyp.
Int J Surg Case Rep 2019; 59:205-207IJ

Abstract

INTRODUCTION

Esophageal diverticula and esophageal fibrovascular polyps are uncommon clinical entities. While an asymptomatic presentation is possible, symptoms, when present, may be dissimilar in their gastrointestinal or respiratory characteristics. Additionally, these findings typically occur in different segments of the esophagus, with polyps occurring most frequently in the cervical esophagus and the midesophagus being the predominant location of pathologic diverticula.

PRESENTATION OF CASE

We report the case of a 55-year-old patient who presented with a two-year history of progressive dysphagia secondary to a large proximal to midesophageal mass. Workup included esophagography, computed tomography, and endoscopy with ultrasound and was initially consistent with a diagnosis of a large esophageal fibrovascular polyp. Upon operative exploration, the mass was found to be a midesophageal diverticulum associated with a leading lipoma. The patient was successfully treated with transthoracic stapled diverticulectomy. At postoperative follow-up the patient was tolerating oral intake with no symptoms of dysphagia.

DISCUSSION

Esophageal diverticula are typically found in the midesophagus and are thought to arise from radial traction secondary to mediastinal inflammation. Esophageal fibrovascular polyps may result from tracheobronchial compression, and esophagography typically identifies a mobile intraluminal mass.

CONCLUSION

Esophageal fibrovascular polyps and diverticula are rare, and a high index of suspicion is important in evaluation of these entities.

Authors+Show Affiliations

Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States.Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States. Electronic address: emcorsini@mdanderson.org.Department of Surgery, University of Cincinnati Medical Center, Cincinnati, OH, United States.Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States.Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31181388

Citation

Mitchell, Kyle G., et al. "A Case Report of a Midesophageal Diverticulum Mimicking a Fibrovascular Esophageal Polyp." International Journal of Surgery Case Reports, vol. 59, 2019, pp. 205-207.
Mitchell KG, Corsini EM, Van Haren RM, et al. A case report of a midesophageal diverticulum mimicking a fibrovascular esophageal polyp. Int J Surg Case Rep. 2019;59:205-207.
Mitchell, K. G., Corsini, E. M., Van Haren, R. M., Walsh, G. L., & Sepesi, B. (2019). A case report of a midesophageal diverticulum mimicking a fibrovascular esophageal polyp. International Journal of Surgery Case Reports, 59, pp. 205-207. doi:10.1016/j.ijscr.2019.05.047.
Mitchell KG, et al. A Case Report of a Midesophageal Diverticulum Mimicking a Fibrovascular Esophageal Polyp. Int J Surg Case Rep. 2019;59:205-207. PubMed PMID: 31181388.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A case report of a midesophageal diverticulum mimicking a fibrovascular esophageal polyp. AU - Mitchell,Kyle G, AU - Corsini,Erin M, AU - Van Haren,Robert M, AU - Walsh,Garrett L, AU - Sepesi,Boris, Y1 - 2019/05/31/ PY - 2019/05/06/received PY - 2019/05/23/revised PY - 2019/05/29/accepted PY - 2019/6/11/pubmed PY - 2019/6/11/medline PY - 2019/6/11/entrez KW - Case report KW - Esophageal diseases KW - Esophageal diverticulum KW - Fibrovascular polyp SP - 205 EP - 207 JF - International journal of surgery case reports JO - Int J Surg Case Rep VL - 59 N2 - INTRODUCTION: Esophageal diverticula and esophageal fibrovascular polyps are uncommon clinical entities. While an asymptomatic presentation is possible, symptoms, when present, may be dissimilar in their gastrointestinal or respiratory characteristics. Additionally, these findings typically occur in different segments of the esophagus, with polyps occurring most frequently in the cervical esophagus and the midesophagus being the predominant location of pathologic diverticula. PRESENTATION OF CASE: We report the case of a 55-year-old patient who presented with a two-year history of progressive dysphagia secondary to a large proximal to midesophageal mass. Workup included esophagography, computed tomography, and endoscopy with ultrasound and was initially consistent with a diagnosis of a large esophageal fibrovascular polyp. Upon operative exploration, the mass was found to be a midesophageal diverticulum associated with a leading lipoma. The patient was successfully treated with transthoracic stapled diverticulectomy. At postoperative follow-up the patient was tolerating oral intake with no symptoms of dysphagia. DISCUSSION: Esophageal diverticula are typically found in the midesophagus and are thought to arise from radial traction secondary to mediastinal inflammation. Esophageal fibrovascular polyps may result from tracheobronchial compression, and esophagography typically identifies a mobile intraluminal mass. CONCLUSION: Esophageal fibrovascular polyps and diverticula are rare, and a high index of suspicion is important in evaluation of these entities. SN - 2210-2612 UR - https://www.unboundmedicine.com/medline/citation/31181388/A_case_report_of_a_midesophageal_diverticulum_mimicking_a_fibrovascular_esophageal_polyp L2 - https://linkinghub.elsevier.com/retrieve/pii/S2210-2612(19)30294-9 DB - PRIME DP - Unbound Medicine ER -