Diffuse Villous Tumor Arising in Barrett's Esophagus Presenting With Aspiration Pneumonitis

Barrett's esophagus (BE) is associated with an increased incidence of adenocarcinoma. The dysplasia in BE that precedes cancer is usually endoscopically flat. Unlike in the colon, polypoid dysplastic lesions superimposed on BE are uncommon. Furthermore, villous tumors of the esophagus are rare, and few cases have been reported in the literature. We report an 85-year-old man who was found to have a circumferential villiform-appearing esophageal tumor with mucus secretions with recurrent bronchopulmonary aspiration. A diffuse villiform tumor of the entire esophagus with mucin production is rare and, to our knowledge, has not been previously described in the literature.