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![Histologic findings of the specimen. Microscopic examination revealed squamous papilloma with papillary epithelial proliferation with the fibrovascular core at low-power magnification (A, Hematoxylin and eosin [H&E] stain, ×40). The squamous cell showed koilocytosis with nuclear irregularity and perinuclear halo (B, H&E stain, ×200).](publication/326482202/figure/fig2/AS:650125399576576@1532013382580/Histologic-findings-of-the-specimen-Microscopic-examination-revealed-squamous-papilloma.png)
Histologic findings of the specimen. Microscopic examination revealed squamous papilloma with papillary epithelial proliferation with the fibrovascular core at low-power magnification (A, Hematoxylin and eosin [H&E] stain, ×40). The squamous cell showed koilocytosis with nuclear irregularity and perinuclear halo (B, H&E stain, ×200).
Source publication
Squamous papilloma is a common benign tumor of the esophagus. Patients with papilloma are usually asymptomatic, and they are diagnosed incidentally during esophagogastroduodenoscopy. Most papillomas are small and easily removed by forceps biopsy. Recurrence of papilloma after removal is rare. Human papilloma virus infection is supposed to play a ro...
Context in source publication
Context 1
... to exclude malignant tumor. Microscopic examination revealed squamous papilloma showing papillary squamous epithelium with a fibrovascular core. Squamous epithelial cells of the pap- illoma showed koilocytosis with irregular nuclear membrane and perinuclear halo, which histologically confirmed the pres- ence of human papillomavirus infection (Fig. ...
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Background
Endoscopic submucosal dissection (ESD) is widely used for en bloc resection in early gastrointestinal cancer. However, it is technically complex with long procedure time and high adverse event rates with using conventional knives. The aim of this animal study was to verify the feasibility of ESD using a novel 980/1470 nm dual diode laser...
Citations
... There have been only a couple of case reports on its malignant transformation. 8,31 None of our cases is associated with malignancy simultaneously or asynchronously or shows progression to cytologic dysplasia or squamous cell carcinoma. Since ESP is typically a small lesion, endoscopic removal with biopsy forceps, snare polypectomy, and cautery is currently considered adequate. ...
Introduction: The etiology of esophageal squamous papilloma (ESP) is largely unknown. Previous studies have shown a variable association with human papillomavirus (HPV) with conflicting data. The aim of this study was to further investigate the possible association of HPV in our ESP series using RNA in-situ hybridization (ISH) and compare study groups from the United States of America and China. Methods: Demographic and clinical data of patients with ESP were retrieved from the University of California Los Angeles (UCLA) (1/2016-3/2019) and Peking Union Medical College Hospital (PUMCH) (9/2014-3/2019) pathology databases. Hematoxylin and eosin slides were reexamined. Confirmed cases were examined by high- and low-risk HPV RNA ISH. Results: For the UCLA cohort, 13 429 upper endoscopies were performed and 78 biopsies from 72 patients were identified as ESP (F:M = 45:27, 66.7% > 45 years). Seventy-four (94.9%) biopsies were designated as polyps or nodules and 46.6% were located in the mid-esophagus. Other abnormal findings included gastroesophageal reflux disease (48.6%), hiatal hernia (38.9%), and esophagitis (36.1%). For the PUMCH cohort, 63 754 upper endoscopies were performed and 73 biopsies from 71 patients were identified as ESP (F:M = 48:23, 71.8% > 45 years). Sixty-four (87.7%) biopsies were designated as polyps or nodules and 57.5% were located in the mid-esophagus. Other abnormal findings included esophagitis (19.7%), and hiatal hernia (8.5%). No features of conventional cytologic dysplasia or viral cytopathic change were found. None of the cases was associated with squamous cell carcinoma, and none showed positive HPV RNA ISH results. Conclusions: No association was found between ESP and active HPV infection in our 2 cohorts. Other etiopathogenetic mechanisms, such as aging, might contribute to the development of these innocent lesions.
... In comparison with other forms of SCP, ESP is an asymptomatic lesion diagnosed incidentally by esophagogastroduodenoscopy (EGD), where it appears as an exophytic growth with crossing surface vessels on narrow-band imaging. 2,3 Its rarity can be partially due to its internal location and asymptomatic nature. ...
Background and Aim
Esophageal squamous papilloma (ESP) is a benign growth in the esophagus with unknown malignant potential. The mechanism underlying ESP formation is unknown, but human papillomavirus (HPV) infection has been proposed as a potential etiology. We sought to investigate the clinical characteristic of ESP in our population, review the current literature, and highlight the role of HPV.
Methods
This is a retrospective case–control study conducted at two referral centers. We selected the ESP population by free‐text search in the pathology department database and selected controls randomly from the general endoscopy population. Immunostains were used to evaluate ESP tissue for HPV.
Results
Between January 2016 and December 2021, we identified 66 patients with ESP, with a prevalence of 0.72%. ESP patients were younger, with a median age of 52 years ( P = 0.021), and more likely African American (34.4 vs 7.5%, P < 0.001) compared to controls. On endoscopy images, the growth was predominantly solitary (92.5%) in the middle of the esophagus (39.4%), with sizes ranging from 0.2 to 2.3 cm. A total of 62 patients had available tissue for HPV immune staining, and none tested positive for HPV. Eighteen patients had a follow‐up endoscopy with an average of 504.5 days follow‐up period. One patient developed esophageal squamous cell carcinoma during follow‐up.
Conclusions
We observed a higher prevalence of ESP compared to previous studies. The formation of ESP is multifactorial and partially explained by HPV infection in selected populations. The malignant potential of ESP is low but not negligible.
... EP was classified as an esophageal benign epithelial tumor and its association with cancer is extremely rare [54,55]. Although only a handful of EPS cases were disclosed, 12 cases were reported to be complicated with esophageal cancer, accounting for approximatively 22.6% of all cases (Table 3). ...
If esophageal papilloma (EP) is a rare condition, esophageal papillomatosis (EPS) is a distinct rarity. To date, only 53 well documented cases have been described in English literature. However, the number of reports on EPS significantly increased to over 40 cases during the past 20 years. Perhaps, this is due to the broad use of endoscopy and related research achievements. Most of the cases are individual and it seems that there are no associations between them. And up to now no guidelines can be followed. To further understand this exceedingly rare disease, we had a comprehensive review of the epidemiology, etiology, clinical manifestations, pathogenesis, treatment, and clinical course of EPS.
... OSP are commonly found in the middle and distal thirds of the oesophagus as solitary and small lesions ranging between 2 and 6 mm in size, although they have been found in all parts of the oesophagus [1][2][3][4][5]. Lesions greater than 10 mm, clusters of lesions and diffuse involvement of the oesophagus have been reported in the literature but are rare [6][7][8]. Endoscopic findings are of a f leshy white-pink coloured lesion with wart-like exophytic projections [2]. Although these macroscopic features are not pathognomonic for OSP, the triad of an exophytic growth, wart-like projections and surface vessels visualized on narrow band imaging as crossing the lesion were found to have a positive predictive value of 88% in one study [2]. ...
... Differential diagnoses include verrucous squamous cell carcinoma, malignant melanoma, leiomyoma, papillary leucoplakia and inf lammatory fibroid polyp. On histopathology, OSPs are characterized by a fibrovascular core of connective tissue and small blood vessels branching out from the lamina propria, and lined by acanthotic stratified squamous epithelium, without dysplastic or neoplastic changes [2,8]. ...
... Other chemical and mechanical factors such as caustic injury, nitrosamine exposure, smoking, alcohol, prolonged nasogastric intubation, and also previous oesophageal dilatation, have been associated with OSP [7]. HPV has been detected in OSP in several studies, with a prevalence of 10-80% reported in the literature [4,5,8,9]. However, the HPV serotypes tested in most studies were either not stated or limited to HPV 6, 11 and 16 such that the association of HPV and OSP may be under-estimated due to the large number of existing HPV serotypes not routinely tested [3,5,9]. ...
Oesophageal squamous papillomas (OSPs) are rare epithelial lesions, recognized to be benign but with reported malignant potential. We report a case of a 40-year-old female with chronic vomiting, subsequently found on oesophago-gastro-duodenoscopy to have two mid-oesophageal sessile polyps, the largest of which measured 10 mm. These were endoscopically resected with histopathology confirming an OSP without evidence of dysplasia or malignancy. The case under consideration reports the current literature on OSPs regarding their aetiology, malignant potential and optimal management.
... Most papillomas are benign, small, and can be easily removed during forceps biopsy. However, owing to the few reported cases of carcinomatous transformation of these lesions, definite removal is necessary if a papilloma bleeds, is unusually large, elicits foreign-body sensation, or shows atypical changes on histological examination [50]. ...
Upper gastrointestinal endoscopy is the most important test used to diagnose esophageal disease. Proper insertion of the endoscope is essential for accurate examination of the esophagus. However, due to coughing or the gag reflex, esophageal examinations can be difficult. Further, when a central ridge is present in the middle of the pyriform sinus, careful approach is necessary. Chromoendoscopy of the esophagus includes acetic acid chromoendoscopy for Barrett’s esophagus and lugol’s iodine chromoendoscopy for squamous cell carcinoma. In recent times, electronic chromoendoscopy is widely used. In this chapter, diagnosis and treatment of various esophageal diseases including esophagitis, Barrett’s esophagus, adenocarcinoma, squamous cell carcinoma, diverticulum, inlet patch, hiatal hernia, polyps, subepithelial lesions, and varix are discussed.
... The margin required to remove the lesion remains controversial, as does the case for ongoing endoscopic surveillance. It is possible that HPV has a carcinogenic effect on OSP [8]. Further understanding of this relationship could further inform management decision of this rare entity. ...
Oesophageal squamous cell papilloma is a very rare entity with a limited number of reports in the literature. The exact aetiology is uncertain, and it commonly overlaps with gastro-oesophageal reflux. Human papilloma virus (HPV) is deemed responsible for some cases. Although incidental discovery during upper gastrointestinal endoscopy for other reasons is the commonest presentation, symptomatic cases do occur. Endoscopic excision is the standard treatment. We report a case of HPV-positive squamous papilloma of the upper oesophagus, presenting with lateralising throat pain and diagnosed with office transnasal oesophagoscopy. We also discuss features of HPV-positive oesophageal squamous papilloma and the role of transnasal oesophagoscopy as a recent diagnostic modality of increasing popularity.
... However, exceedingly rare papillomatosis carries significant malignant potential. [2][3][4][5] The lesions are generally amenable to endoscopic resection. Lesions smaller than 1 cm can usually be removed with biopsy forceps, but larger lesions require endoscopic mucosal resection. ...
... However, exceedingly rare papillomatosis carries significant malignant potential. [2][3][4][5][6] In a French study, 1 out of 78 cases (1.3%) of esophageal papilloma developed into squamous cell carcinoma at a follow-up of 2 years. [2] In our patient, the biopsy of the lesion was negative for dysplasia or malignancy. ...
... The patients with extensive ESPs have been treated with endoscopic resection, radiofrequency ablation, cryotherapy, and laser, as well as oesophagectomy in a few cases. [1][2][3][4][5][6]9,10] The clinical course in our patient was unusual as the lesion was shed off spontaneously, leaving behind a residual stalk, which was snared and removed endoscopically. ...
Introduction:
The esophageal squamous papilloma (ESP) is a rare cause of dysphagia and hematemesis. The malignant potential of this lesion is uncertain; however, the malignant transformation and concurrent malignancies have been reported in the literature.
Case description:
We report a case of esophageal squamous papilloma in a 43 years old female who had a background diagnosis of metastatic breast cancer and liposarcoma of the left knee. She presented with dysphagia. Upper gastrointestinal (GI) endoscopy showed a polypoid growth, and its biopsy confirmed the diagnosis. Meanwhile, she presented again with hematemesis. A repeat endoscopy showed that the previously seen lesion had likely broken off, leaving behind a residual stalk. This was snared and removed. The patient remained asymptomatic, and a follow-up upper GI endoscopy at six months did not show any recurrence.
Practical implications:
To the best of our knowledge, this is the first case of ESP in a patient with two concurrent malignancies. Moreover, the diagnosis of ESP should also be considered when presenting with dysphagia or hematemesis.
... However, the spread of cancer cells cannot be controlled when the radiotherapy measures are implemented, so the incidence of adverse reactions is higher after treatment [13,14], which leads to greater psychological pressure of patients, directly affects their psychological state and quality of life, and has a certain negative impact on the therapeutic effect [15,16]. Moreover, radiation injury to esophageal mucosa is one of the most common side effects of radiotherapy, which can lead to mucosal edema, congestion, ulcer, and erosion causing patients to feel esophageal burning, esophageal swelling and pain, and then suffering from dysphagia, swallowing pain, pain behind the sternum, and other symptoms when eating [17][18][19]. erefore, the implementation of scientific and effective rehabilitation training and health guidance is conducive to improve the swallowing function for esophageal cancer patients with difficulty in opening mouth after radiotherapy, so as to supplement enough nutrition and water to improve the body's resistance, which is of great significance for the rehabilitation of disease and psychology. In this study, rehabilitation nursing was mainly used to intervene patients with esophageal cancer undergoing radiotherapy and observe its application effect. ...
Objective:
To seek the improvement of rehabilitation nursing intervention on dysphagia and quality of life of patients with esophageal cancer undergoing radiotherapy.
Methods:
A total of 109 patients with esophageal cancer undergoing radiotherapy were selected as research objects. According to the random number table, they were separated into the control group (CG) and intervention group (IG), with 45 cases in CG and 64 cases in IG. In CG, patients were given routine nursing intervention, while those in IG were given rehabilitation nursing intervention. After intervention, the degree of acute radiation injury and the improvement of swallowing function were observed to compare the self-nursing ability, quality of life, and incidence of complications between the two groups.
Results:
The degree of injury in CG was heavier than that in IG. The improvement of swallowing function in IG was better than that in CG. The scores of self-nursing ability and life quality in IG were higher than those in CG, with statistically significant differences (p < 0.05). The incidence of complications in IG was obviously lower than that in CG (p < 0.05).
Conclusion:
Rehabilitation nursing intervention can ameliorate dysphagia, improve the quality of life, and reduce the incidence of complications for patients with esophageal cancer undergoing radiotherapy. It is worthy of clinical application.
... Case Reports in Gastrointestinal Medicine e etiology is unclear. Chronic mucosal irritation from GERD or esophagitis is the prevailing theory of pathogenesis, but HPV (human papillomavirus)-strongly associated with cervical, anal, and oropharyngeal cancers (depending on viral serotype)-has been detected in some lesions [1,4]. A study comparing clinicopathological characteristics of Japanese patients to western countries identified 38 esophageal squamous papillomas (ESPs) in 35 patients over a period of 13 years and noted four tumors in four female patients (10.5%) tested positive for HPV subtype 6 [1]. ...
... Complications with squamous cell carcinoma (SCC) have been reported [3][4][5][6]; however, the small absolute number of cases makes drawing any associations or conclusions between ESP and SCC difficult [12]. Review of the literature seems to suggest malignant potential appears highest in cases where the patient is symptomatic and has multiple lesions (papillomatosis), or a particularly large lesion [5,6]. ...
... e gold standard for evaluation is biopsy. ere are various proposed therapies for squamous papillomas including forceps biopsy resection, cautery, radiofrequency ablation, mucosectomy for larger lesions, and potentially esophagectomy if presentation is extreme and does not respond to more conservative therapy [4,5,11,13,14]. Future research is needed regarding treatment and surveillance for these lesions. ...
Esophageal squamous papillomas are rare epithelial lesions typically discovered incidentally during EGD. Their prevalence is estimated to be less than 0.01% in the general population. We present three cases of esophageal squamous papillomas identified histologically. It may be possible to identify these lesions macroscopically. One study provided a positive predictive value of 88% for squamous papilloma utilizing the triad of exophytic growth, wart-like projections, and surface vessel crossing seen on narrow band imaging during endoscopy. The etiology is unclear. Chronic mucosal irritation from GERD or esophagitis is the prevailing theory of pathogenesis, but HPV has been detected in some lesions. The malignant potential of these lesions is considered controversial. There are documented cases demonstrating complications with squamous cell carcinoma, so we recommend removal of all esophageal squamous papillomas; however, the small absolute number of cases documented in the literature makes drawing any associations or conclusions between esophageal squamous papillomas and squamous cell carcinoma difficult. Further research is needed regarding treatment and surveillance. This case series helps contribute to the small but growing literature of this rare finding.
