Peroral endoscopic tumor resection of recurrent hypopharyngeal fibrovascular polyp

Background and Aims

Fibrovascular polyps (FVPs) are rare benign submucosal tumors of the pharynx and cervical esophagus that can cause dysphagia and airway obstruction. We report the successful endoscopic resection of a recurrent FVP in the hypopharynx using peroral endoscopic tumor resection techniques in combination with pharyngeal endoscopic treatment strategies. A 56-year-old woman presented with a recurrent FVP in the right arytenoid region after an incomplete resection. Because of tumor growth and worsening dysphagia, we opted to perform the endoscopic resection after thorough evaluation.

Methods

The procedure was performed with the patient under general anesthesia. Intra- and postoperative airway management was secured with temporary percutaneous cricothyrotomy. Laryngeal expansion was performed with a curved rigid laryngoscope to enhance visualization. Endoscopic resection was performed with a minimal mucosal incision, followed by enucleation of the tumor, and closure of the mucosa. En bloc enucleation of the tumor was achieved without damaging its surface using string-clip traction.

Results

The patient was discharged on postoperative day 6 without adverse events. Pathologic examination confirmed complete resection of the FVP.

Conclusions

Endoscopic resection using combined peroral endoscopic tumor resection techniques and pharyngeal endoscopic treatment strategies offers a safe and minimally invasive treatment option for hypopharyngeal FVPs.