Fibrovascular Polyps of the Hypopharynx and Esophagus

Abstract

Objectives: Fibrovascular polyps of the hypopharynx and esophagus are rare, and the majority of the literature is comprised of case reports. The goals of this study are: 1) Present one of the largest series of patients from a single institution that presented with fibrovascular polyps; 2) Describe their presentation focusing on airway management and clinical demographics; 3) Discuss our surgical management and demonstrate how it has evolved from open to endoscopic approaches. Methods: A retrospective review was conducted with four patients that presented to a tertiary medical center with fibrovascular polyps between 1990 and 2012. Patient demographics, clinical presentations, surgical approaches, and diagnostic studies were analyzed. Results: The average age at presentation was 72 years (range 59 to 85 years). Among the four patients, two presented with airway compromise requiring tracheotomy. All patients had removal of the polyp shortly after presentation; two underwent transcervical approaches with lateral pharyngotomy/esophagotomy; and the other two had endoscopic removal. The polyps arose from the hypopharynx in three patients and upper esophagus in one. Three patients had complete resolution of their symptoms and remained disease free. One patient had recurrence of the polyp two years later and is currently being observed. Conclusions: Fibrovascular polyps are rare tumors of the hypopharynx/esophagus that occur among older patients. Although benign, they can cause life threatening airway compromise that may necessitate tracheotomy. We present four cases of fibrovascular polyps and discuss our evolving surgical management. We demonstrate that endoscopic removal is a viable option for these tumors.