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March 27, 2015  
EDUCATION CENTER: Clinical Overview

Clinical Overview
Diagnosis and Treatment

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  • Esophageal Polyps

    Clinical Overview
    Reviewed by Richard Alweis, MD

    An esophageal polyp is a type of abnormal growth that protrudes from the lining of the esophagus. Esophageal polyps are rather rare in the general population, and in a broad-spectrum autopsy study were identified with a frequency of only 0.5%. Additionally, these growths or "neoplasms" are more common in men than women, and generally do not occur until middle age. When esophageal polyps do result, they are most often asymptomatic and benign, and do not require treatment.

    The most common esophageal polyp is the leiomyoma. This is a benign growth that usually presents itself as a smooth, round projection from the esophageal wall. Although most patients do not report any symptoms associated with leiomyoma, some experience dysphagia or chest pain. Dysphagia is a swallowing disorder characterized by difficulty or pain during the process of passing food from the mouth to the stomach.

    Another type of esophageal polyp that may develop is a squamous cell papilloma. These neoplasms usually develop at several areas in the esophagus simultaneously, and form "frond-like" protrusions. These protrusions are not usually large enough to cause dysphagia or other symptoms, however. Squamous cell papilloma usually develops along the lower third of the esophagus, and is three times more likely to appear in men than women. Squamous cell papilloma is usually considered benign, and does not usually correlate with the development of squamous cell carcinoma.

    Unlike leiomyoma or squamous cell papilloma, the fibrovascular esophageal polyp stands out in that it grows so large that it almost always produces symptoms. The fibrovascular polyp grows into a large stalk form, up to 50 cm long, and is constructed of loose fibrous connective tissue, fat, and blood vessels, covered by a layer of epithelium cells. These polyps usually develop in the upper third of the esophagus. In one study, 87% of patients with fibrovascular polyps reported dysphagia, 25% had respiratory problems, and 12% had experienced partial regurgitation of the top of the stalk into their mouth or throat. This type of esophageal polyp is also benign, but is very, very rare.

    Granular cell tumors represent yet another class of benign esophageal polyps, but are far more likely to occur in other sites such as the tongue, skin, and subcutaneous tissue. Such polyps are benign and usually do not cause any symptoms.

    Last updated: Jul-01-08


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