Konwisorz A, Reißmann N, Hagen R, Müller J G, Scheppach W
Medizinische Klinik, Schwerpunkt Gastroenterologie/Rheumatologie, Juliusspital Würzburg, Germany.
Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Germany.
Z Gastroenterol. 2015 Oct;53(10):1183-6. doi: 10.1055/s-0035-1553349. Epub 2015 Oct 19.
Fibrovascular polyps are rare mesenchymal tumors that arise mainly in the cricopharyngeal portion of the esophagus. They may protrude distally to become "giant" pedunculated lesions filling almost the entire esophageal lumen. Histologically they contain varying amounts of adipose, fibrous and vascular tissues and belong to spindle cell lipomas according to the classification of soft tissue tumors. Immediate resection of these benign lesions is warranted as they may be regurgitated and cause asphyxia. These lesions are usually treated by open surgery (left cervicotomy) or, less invasively, by peroral endoscopic surgery. Polyp removal by flexible endoscopy has been described but may be hazardous if its stalk is broad-based. In this report the case of a 73-year-old male with dysphagia is described in whom a "giant" fibrovascular polyp was diagnosed endoscopically and promptly removed surgically by the peroral route. At control endoscopy 14 months later, the asymptomatic patient was free of polyp recurrence.
纤维血管性息肉是一种罕见的间充质肿瘤,主要发生在食管的环咽部分。它们可能向远端突出,成为几乎填满整个食管腔的“巨大”带蒂病变。组织学上,它们含有不同数量的脂肪、纤维和血管组织,根据软组织肿瘤的分类属于梭形细胞脂肪瘤。由于这些良性病变可能会反流并导致窒息,因此需要立即切除。这些病变通常通过开放手术(左颈切开术)治疗,或者采用侵入性较小的经口内镜手术治疗。已经有通过柔性内镜切除息肉的报道,但如果其蒂部较宽,则可能有危险。在本报告中,描述了一名73岁吞咽困难男性的病例,该患者经内镜诊断为“巨大”纤维血管性息肉,并通过经口途径迅速进行了手术切除。在14个月后的对照内镜检查中,该无症状患者未出现息肉复发。