Treatment of Benign Esophageal Tumor in Pedunculated Esophageal Lipoma / Fibrovascular Polyp with Risk of Asphyxia
Pedunculated lipomas and fibrovascular polyps arising in the proximal or upper esophagus represent a clinically distinct subset of benign esophageal tumors. Unlike incidentally found tumors managed expectantly, the pedunculated location in the upper esophagus introduces a direct asphyxia risk that drives a clear indication for intervention.
Lipomas are usually discovered incidentally on radiologic imaging or endoscopy, but a pedunculated proximal polyp or lipoma in the upper esophagus carries a significant risk of asphyxia — a factor that elevates clinical urgency and shapes the management decision beyond routine surveillance.
Approach to Management
The protocol for this scenario centres on a resection-based strategy — either interventional-endoscopic or surgical in nature. The specific modalities considered, the criteria for selecting among them, and the procedural algorithm are detailed in the full structured protocol.
References
- Lipomas are usually discovered incidentally on radiologic imaging or endoscopy, but pedunculated proximal polyps/lipoma carries a risk of asphyxia.
- The indication for resection may also be due to compression of extraesophageal organs by large tumors or the risk of asphyxia in pedunculated polyps in the upper esophagus.
- Treatment options include interventional-endoscopic and surgical procedures up to esophagectomy.
DOI: 10.1515/iss-2023-0011
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