Regurgitation of a mass into the mouth: a fibrovascular polyp of the esophagus.

with a 6-month history of intermittent regurgitation of a mass into his mouth. Laryngoscopy revealed a smooth mass in the pharynx; this mass had prolapsed from the esophagus (●" Fig. 1a,b). Esophagogastroduodenoscopy revealed a sausage-shaped pedunculated mass covered with normal esophageal epithelium arising from the cervical esophagus just below the cricopharyngeus muscle and extending up to 25 cm distal to the incisor (●" Fig. 2a– c). The T1and T2-weighted magnetic resonance images showed a hyperintense mass, and a T2-weighted image with fat suppression showed a drop in signal intensity (●" Fig. 3a– c). Transoral resection was performed under general anesthesia by direct visualization (●" Fig. 4). Histologic studies showed that the polyp had fibrous and vascular components as well as adipose tissue covered with normal squamous epithelium (●" Fig. 5). Fibrovascular polyps (FVPs) of the esophagus are rare benign tumors that are typically large and pedunculated and arise from the cervical esophagus [1]. A previous study reported that 75% of these polyps were 7 cm or longer at the time of presentation [1,2]. In the past, FVPs have been referred to as fibromas, fibrolipomas, myxofibromas, and pedunculated lipomas, depending on the major component. However, the World Health Organization recommends that all these types be grouped together as FVPs. Magnetic resonance imaging is useful for characterizing polyp components. Although patients with such polyps often present with dysphagia, there are some reports of serious and potentially fatal complications, including sudden death due to asphyxiation secondary to regurgitation into themouth [3–5]. Some clinicians may disregard a patient’s complaint of regurgitation of a mass; however, as this can be an imminent sign of the presence of a potentially fatal polyp, careful examination, accurate diagnosis, and early intervention are mandatory.