Case 35 - Fibrovascular polyp

Summary

Imaging description

Fibrovascular polyps are intraluminal masses that demonstrate mixed attenuation by CT. These pedunculated masses are usually smooth and sausage-shaped (Figure 35.1). They typically arise from the cervical esophagus. They extend inferiorly into the thoracic esophagus and can measure up to 25 cm in length. The diameter of a fibrovascular polyp is usually much greater than the diameter of the esophagus; consequently, these polyps distend the esophagus. Sometimes a longitudinal artery is demonstrated in the center of the polyp by CT with intravenous contrast material [1]. Esophagram confirms an intraluminal mass (Figure 35.2).

Importance

Fibrovascular polyps are rare, benign masses consisting of variable amounts of fibrous, vascular, and adipose tissue covered by normal squamous epithelium [2]. Imaging identification of fibrovascular polyps is important since up to 25% of these polyps are missed at endoscopy because they are covered with normal squamous epithelium [3]. Excision of fibrovascular polyps solves two significant problems: (1) progressive dysphagia and (2) the risk of airway obstruction and asphyxiation caused by regurgitation of the polyp into the pharynx [4]. Fibrovascular polyps do not undergo malignant degeneration.