A 23-year-old woman presented to the clinic with complaints of heartburn and dysphagia with solid foods. Her family history was remarkable for gastric and lung cancer in first-degree relatives. Her physical examination and routine laboratory study results were normal. An upper endoscopy was performed and showed multiple polypoid lesions ranging in size from 3 to 11 mm, involving the entire esophagus (Figure A; Video). An endoscopic polypectomy of several of the larger polyps was performed. Histopathologic examination showed the lesions were squamous papillomas with areas of hyperkeratinization. No dysplastic cells, no inclusion body, and no cytopathic effects were detected (Figure B). Proton pump inhibitor therapy was initiated. Although the patient was human papillomavirus (HPV) negative, she was given the HPV vaccine at the recommendation of Infectious Disease consultants. At a follow-up visit, the patient’s symptoms were improved. Esophageal squamous papillomas are benign epithelial lesions of the esophagus. Incidence has ranged from 0.01% to 0.45%. They are seen as small, whitish-pink, wart-like, exophytic projections. The etiology includes chronic mucosal irritation caused by acid reflux, prolonged nasogastric intubation, smoking, alcohol, and HPV infection. Most lesions cause no symptoms. Lesions smaller than 1 cm usually can be removed by endoscopy, with larger lesions often requiring endoscopic mucosal resection. The prognosis of esophageal squamous papillomas ranges from spontaneous regression to malignant transformation. Malignant transformation has been associated with esophageal stricture, dysphagia, and virulent HPV strains. Informed consent was obtained from the patient for being included in this case report. eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiJhOTM5MDZlMTNjNzI4NDQwNzhlOWU1N2Y2YWY1NGQ4ZSIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjc3OTIwOTIxfQ.ShMkXA5cnn9twry6blcELzlJlmN9784wyzNJ-9ScuTbCXJKYJnhyCAugAlFFQ55xweFf4fR3nO_6-081CiSDBdhjODD3NnID000tmjVJjK-91U-d0ZDzC7juN8xIhmtq8g4Ppt8-QapgjJfBVMUzndBH6Wc8YbReuOgZnL1NonQjPVhenCZCSZQtwaVivSsKPsrfN8bQPsNdp3LVN0Egdg1a12YEmOmvFIk4YtE4nlSgAtzucgvGYeNe8elajLusOAxAO2NIOjp5Dlc0U7PH50bEutnwTCExs2tTImgjRmKSfH3wa6iJNElKAS4Y73Ig2VuFq2SwhrH3tZqILA6TQA Download .mp4 (2.83 MB) Help with .mp4 files Video