Dual-scope-assisted endoloop resection of a giant esophageal fibrovascular polyp.

BACKGROUND AND AIMS: Giant fibrovascular polyps of the esophagus are rare benign tumors. Although open surgery has been the standard treatment, it carries significant morbidity. Endoscopic resection is a promising alternative, but experience with large lesions remains limited. We report a case illustrating its feasibility and safety.

METHODS

An 86-year-old man with comorbidities presented with progressive dysphagia and oral protrusion of a soft mass. Endoscopy revealed a 10-cm pedunculated polyp distal to the cricopharyngeus. CT showed no invasion or lymphadenopathy. Resection was performed with the patient under general anesthesia using a dual endoscope technique to place an endoloop, followed by hot snare excision and thermocoagulation.

RESULTS

The resection was completed successfully without intraoperative adverse events. After the procedure, the patient experienced aspiration-related pneumonia, which was managed with intravenous antibiotics. The patient was discharged in good general condition. No recurrence was observed during 2 years of clinical and endoscopic follow-up.

CONCLUSIONS

Endoscopic resection is a safe and effective minimally invasive option for giant esophageal polyps, even in high-risk patients, and may be considered as a first-line treatment.