Dual-scope-assisted endoloop resection of a giant esophageal fibrovascular polyp

Giant fibrovascular polyps of the esophagus are rare benign tumors. Although open surgery has been the standard treatment, it carries significant morbidity. Endoscopic resection is a promising alternative, but experience with large lesions remains limited. We report a case illustrating its feasibility and safety.

An 86-year-old man with comorbidities presented with progressive dysphagia and oral protrusion of a soft mass. Endoscopy revealed a 10-cm pedunculated polyp distal to the cricopharyngeus. CT showed no invasion or lymphadenopathy. Resection was performed with the patient under general anesthesia using a dual endoscope technique to place an endoloop, followed by hot snare excision and thermocoagulation.

The resection was completed successfully without intraoperative adverse events. After the procedure, the patient experienced aspiration-related pneumonia, which was managed with intravenous antibiotics. The patient was discharged in good general condition. No recurrence was observed during 2 years of clinical and endoscopic follow-up.

Endoscopic resection is a safe and effective minimally invasive option for giant esophageal polyps, even in high-risk patients, and may be considered as a first-line treatment.