Abstract
Question: A 35-year-old man with Lynch syndrome presented for evaluation of progressive solid food dysphagia of 2 months’ duration. Lynch syndrome was confirmed by MSH2 mutation testing and family history of young-onset colon cancer. Annual screening colonoscopies since age 25 were normal. Upper endoscopy revealed a 1.5-cm, pedunculated polyp in the proximal esophagus just below the cricopharyngeus (Figure A). Endoscopic ultrasonography of the lesion showed it was confined to the mucosal layer without periesophageal lymphadenopathy. Computed tomography revealed an intraluminal mass at the cervical esophagus without local extension. The polyp was then removed completely using standard polypectomy techniques (Figures B and C). What is the diagnosis? Look on page 1167 for the answer and see the GASTROENTEROLOGY web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI.
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