RESUMEN
Giant fibrovascular polyps of the esophagus and hypopharynx are benign tumors of the upper digestive tract. Although a rare cause of asphyxiation, laryngeal impaction by a regurgitated polyp of the esophagus may be the initial symptom that brings the patient to request medical attention. Two new cases of giant fibrovascular polyps with dramatic and potentially life-threatening presentations illustrate the unpredictable behavior of these unusual tumors. Both patients presented to the emergency center with a history of coughing and eructation followed by temporary airway obstruction that was relieved by clenching a regurgitated fleshy mass between the teeth. Diagnostic and therapeutic intervention requires aggressive airway management, radiographic and endoscopic evaluation, and definitive surgical treatment. Tracheotomy was required in one patient, and successful endotracheal intubation provided satisfactory airway control in the second. Esophagoscopy revealed the origin of both tumors to be near the cricopharyngeal muscle. Complete surgical excision was curative in both cases.
Asunto(s)
Obstrucción de las Vías Aéreas/etiología , Neoplasias Esofágicas/complicaciones , Hipofaringe , Neoplasias Faríngeas/complicaciones , Pólipos/complicaciones , Anciano , Neoplasias Esofágicas/patología , Neoplasias Esofágicas/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Faríngeas/patología , Neoplasias Faríngeas/cirugía , Pólipos/patología , Pólipos/cirugíaAsunto(s)
Coristoma/patología , Esófago , Neoplasias Gástricas/patología , Adulto , Anciano , Esófago de Barrett/patología , Transformación Celular Neoplásica , Coristoma/complicaciones , Diagnóstico Diferencial , Endoscopía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Gástricas/complicacionesRESUMEN
Granular cell tumors, (formerly called myoblastomas) involving the esophagus were encountered in three patients. In all three the tumors were asymptomatic and in two they were multiple. The first published endoscopic photographs of such a tumor are presented. The successful total removal of this neoplasm using the endoscope is described. The pathologic, radiologic and therapeutic aspects of previously reported cases of granular cell tumor of the esophagus are reviewed and compared with the three reported herein.
Asunto(s)
Neoplasias Esofágicas/patología , Neoplasias de Tejido Muscular/patología , Adulto , Autopsia , Biopsia , Esofagoscopía , Esófago/patología , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Seventy-three upper gastrointestinal endoscopic polypectomies were performed in 63 patients over a period of five years. Thiry-eight patients (52%) had adenomatous polyps, two of which contained carcinoma in situ and 26 (36%) were inflammatory in nature. Four lesions were removed from the duodenum. Hemodynamically significant hemorrhage occurred in five cases and persistent symptomatic ulcer in three cases. All complications occurred early in the series and responded to conservative measures. There was no mortality or need for surgical intervention in any case. It was concluded that: 1. upper gastrointestinal tract endoscopic polypectomy is a safe and relatively simple procedure; 2. postprocedural complications can be markedly reduced by prophylactic conservative antiulcer therapy and 3. especially in the area of adenomatous polyps, excision of the entire lesion is superior to biopsy in the detection of early malignancy.