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Fibrovascular Polyp of the Esophagus

A 75-year-old patient came to our department for evaluation and treatment of bilateral vocal cord paralysis. Six months earlier she had undergone an emergency intubation in another hospital for respiratory failure during an exacerbation of ischemic heart disease. She was intubated for 6 days, and shortly after extubation stridor and dyspnea developed. Bilateral vocal cord paralysis was detected, and a tracheostomy was performed. On admission to our department she reported sensing a lump in her throat while coughing. A CT scan of the neck did not reveal any abnormality except for the adducted vocal cords, and findings of a barium swallow were normal. Fiberoptic laryngoscopy revealed bilateral vocal cord paralysis with the cords in a paramedian position. No other laryngeal abnormalities were detected. During the examination she started to cough, and a big polypoid mass suddenly appeared from the postcricoid area and obstructed the laryngeal inlet. After the patient stopped coughing, the mass disappeared. With the patient under general anesthesia, we performed a rigid esophagoscopy, which revealed a large polypoid lesion arising from the upper cervical esophagus (Fig. 1). We removed the lesion endoscopically using snare and cautery with minimal bleeding. This was followed by left-sided arytenoidectomy. Pathologic examination revealed a fibrovascular polyp. Several weeks later the patient was successfully decannulated, and since then she has been free of any of the above symptoms.