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 Table of Contents  
CASE REPORT
Year : 2015  |  Volume : 27  |  Issue : 1  |  Page : 40-41

Esophageal squamous papilloma


1 Department of Hepatology and Gastroenterology, Mansoura Specialized Medical Hospital, Mansoura, Egypt
2 Department of Pathology, Mansoura Faculty of Medicine, Mansoura, Egypt

Date of Submission01-Nov-2014
Date of Acceptance10-Nov-2014
Date of Web Publication27-Apr-2015

Correspondence Address:
Seham M Seif
Mansoura Faculty of Medicine, Mansoura 35516
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-7782.155858

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  Abstract 

Squamous papilloma of the esophagus is a rare benign tumor with less than 200 cases reported in the literature. The etiology and pathogenesis appear to be related to an inflammatory-reparatory type, such as chronic gastroesophageal reflux, esophagitis, trauma, chemical irritants, and viruses. We present the case of a young female patient with esophageal squamous papilloma discovered accidently during screening upper gastrointestinal endoscopy.

Keywords: Esophagus, human papillomavirus, squamous papilloma


How to cite this article:
Seif SM, Altonbary AY, Elkashef WF. Esophageal squamous papilloma. Egypt J Intern Med 2015;27:40-1

How to cite this URL:
Seif SM, Altonbary AY, Elkashef WF. Esophageal squamous papilloma. Egypt J Intern Med [serial online] 2015 [cited 2019 Jul 20];27:40-1. Available from: http://www.esim.eg.net/text.asp?2015/27/1/40/155858


  Introduction Top


Squamous papilloma of the esophagus is a rare benign tumor with less than 200 cases reported in the literature [1]. The prevalence of endoscopically diagnosed papilloma of the esophagus has been reported in only a few series and varies from 0.01 to 0.43% [2], and only seven squamous papillomas of the esophagus were recognized in 52 148 autopsies (0.013%) reported up to 1968 [3]. In addition, a case of squamous cell papillomatosis of the esophagus has been described in a patient following placement of a self-expanding metal stent [4].


  Case report Top


A 46-year-old women presented to our unit for screening upper gastrointestinal endoscopy before interferon therapy. The patient had chronic hepatitis C with mild splenomegaly. The endoscopy revealed a diminutive polypoid lesion in the upper third of the esophagus [Figure 1], which was removed with biopsy forceps [Figure 2]. Histological examination of the specimens was compatible with esophageal squamous papilloma with no evidence of viral inclusions [Figure 3] and [Figure 4].
Figure 1: Endoscopic image showing a diminutive polypoid lesion in the upper third of esophagus.

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Figure 2: Endoscopic image showing removal of the lesion with biopsy forceps.

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Figure 3: Hyperplastic stratified squamous epithelium with hyperkeratosis.

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Figure 4: Polypoid lesion covered by hyperplastic stratified squamous epithelium. The connective tissue core showing mild inflammatory reaction.

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  Discussion Top


Esophageal squamous papilloma is an uncommon benign squamous epithelial polypoid tumor and is usually identified as a solitary lesion of the lower esophagus [5]. The etiology and pathogenesis of esophageal squamous papilloma appear to be related to an inflammatory-reparatory type, such as chronic gastroesophageal reflux, esophagitis, trauma, chemical irritants, and viruses [6]. Their malignant potential is still unclear, and it has been proposed that human papillomavirus plays an etiopathogenic role; however, human papillomavirus is not consistently identified [7]. It occurs in patients across a wide age range, mostly in adults aged between 18 and 80 years, with an average of 50 years at the time of diagnosis [6]. Generally, a papilloma appears as a single, round, mulberry-like or dome-shaped elevated solid formation that is well-distinguished from the surrounding tissue. Some authors have reported multiple lesions, but only a few cases of esophageal papillomatosis have been reported [8],[9]. Follow-up is still rather insufficient in the literature. Thirty-five patients were followed up from 2 weeks to a maximum of 4 years. In two of them, the papilloma gradually disappeared and reached complete regression without special treatment. Two other papillomas had grown in diameter during the period of 6 months and 3 years. Three lesions recurred after 2, 6 months, and 1 year from endoscopic removal [10].


  Acknowledgements Top


Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Katsanos KH, Christodoulou DK, Tsianos EV. Esophageal squamous papilloma. Ann Gastroenterol 2005; 18:456-457.  Back to cited text no. 1
    
2.
Mosca S, Manes G, Monaco R, Bellomo PF, Bottino V, Balzano A. Squamous papilloma of the esophagus: longterm follow-up. J Gastroenterol Hepatol 2001; 16:857-861.  Back to cited text no. 2
    
3.
Attah EB, Hajdu SI. Benign and malignant tumors of the esophagus at autopsy. J Thorac Cardiovasc Surg 1968; 55:396-404.  Back to cited text no. 3
    
4.
Karras PJ, Barawi M, Webb B, Michalos A. Squamous cell papillomatosis of the esophagus following placement of a self-expanding metal stent. Dig Dis Sci 1999; 44:457-461.  Back to cited text no. 4
    
5.
Kato H, Orito E, Yoshinouchi T, Ueda R, Koizumi T, Yoshinouchi M, Mizokami M Regression of esophageal papillomatous polyposis caused by high-risk type human papilloma virus. J Gastroenterol 2003; 38:579-83.  Back to cited text no. 5
    
6.
Orlowska J, Jarosz D, Gugulski A, Pachlewski J, Butruk E. Squamous cell papillomas of the esophagus: report of 20 cases and literature review. Am J Gastroenterol 1994; 89:434-7.  Back to cited text no. 6
    
7.
Talamini G, Capelli P, Zamboni G, Mastromauro M, Pasetto M, Castagnini A, et al. Alcohol, smoking and papillomavirus infection as risk factors for esophageal squamous-cell papilloma and esophageal squamous-cell carcinoma in Italy. Int J Cancer 2000; 86:874-8.  Back to cited text no. 7
    
8.
Brinson RR, Schuman BM, Mills LR, Thigpen S, Freedman S. Multiple squamous papillomas of the esophagus associated with Goltz syndrome. Am J Gastroenterol 1987; 82:1177-9.  Back to cited text no. 8
    
9.
Fekete F, Chazouilleres O, Ganther V. Esophageal papillomatosis in the adult: a case report with a survey of the literature. Dis Esophagus 1989; 2:51-56.  Back to cited text no. 9
    
10.
Kawaura Y. Squamous cell papilloma of the esophagus: report of 17 cases and review of the literature. Esophagus 2005; 2:161-164.  Back to cited text no. 10
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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