Esophageal Squamous Papilloma: An Unusual Cause of Dysphagia

Esophageal squamous papilloma (ESP) is a rare benign epithelial tumor of the esophagus with an endoscopic prevalence of 0.01% to 0.43%. It is most commonly discovered incidentally during upper endoscopy in asymptomatic patients. Symptomatic presentation, particularly dysphagia, is uncommon and infrequently reported in the literature. We present the case of a 58-year-old female with a three-month history of progressive dysphagia to both solids and liquids, along with intermittent epigastric pain. Esophagogastroduodenoscopy (EGD) revealed a solitary 3 mm sessile polyp in the middle third of the esophagus, which was successfully resected using cold biopsy forceps. Histopathology confirmed ESP, demonstrating papillary proliferation of non-dysplastic stratified squamous epithelium with fibrovascular cores, variable parakeratosis, spongiosis, and mild basal cell hyperplasia. Following resection, the patient experienced complete resolution of her dysphagia. Concurrently, gastric biopsies revealed active Helicobacter pylori (H. pylori) gastritis, for which standard triple eradication therapy was initiated. This case highlights ESP as a rare but clinically important etiology in the workup of unexplained dysphagia, demonstrates the curative potential of endoscopic resection even for small lesions, and reinforces the need for awareness of this entity among clinicians evaluating upper gastrointestinal symptoms.