Choked for Over a Decade: A Rare Case of Huge Esophageal Fibro-vascular Polyp Causing Dysphagia

Abstract

Introduction: Esophageal fibro-vascular polyps (EFVPs) are rare benign tumors that can arise from the submucosa of the esophagus. They are usually asymptomatic but can cause obstruction and dysphagia in some cases. The diagnosis of EFVPs can be challenging due to their rarity and nonspecific symptoms. Delayed diagnosis can result in significant morbidity, as in the case of our patient who suffered from difficulty swallowing for over a decade before being accurately diagnosed. We present a case of a 42-year-old male patient with a 12-year history of difficulty swallowing, who was eventually diagnosed with a huge fibro-vascular polyp after undergoing thoracotomy esophagostomy and excision of the polyp. Case Presentation: A 42-year-old male patient presented to Hallelujah General Hospital, with a 12-year history of difficulty swallowing, associated with symptoms such as weight loss, fatigue, and asphyxiation while vomiting. The patient had visited several health centers but was unable to receive an accurate diagnosis or effective treatment. Initial investigations revealed a large, smooth, and mobile mass in the mid-esophagus, which was obstructing the lumen and causing difficulty swallowing. A CT scan of the chest and abdomen showed a large polypoid mass in the upper and mid-esophagus, measuring 25 cm in length and 10 cm in diameter, which was confirmed to be an esophageal fibro-vascular polyp upon surgical excision and biopsy. Conclusion: EFVPs are rare, benign tumors of the esophagus that can cause significant morbidity if not diagnosed and treated promptly. The diagnosis of EFVPs can be challenging, and imaging studies such as CT scans, MRI, and endoscopic ultrasound can be helpful in diagnosing the condition. However, a definitive diagnosis usually requires histological examination of the excised mass. Surgical excision is the treatment of choice for EFVPs, and the prognosis is usually excellent. This case report highlights the importance of considering rare conditions in the differential diagnosis of common symptoms, particularly if the patient does not respond to initial treatment. It also emphasizes the importance of early diagnosis and prompt surgical intervention in preventing complications and improving outcomes for patients with EFVPs.