The Mysterious Diver: A Case Report of a Giant Esophageal Fibrovascular Polyp With Intermittent Oral Cavity Prolapse

Fibrovascular polyps of the esophagus are uncommon, benign intraluminal growths. Their gradual growth and vague symptoms often lead to delays in diagnosis, placing patients at risk for serious complications such as sudden airway obstruction caused by regurgitation. We present a case involving a 56-year-old woman who experienced a two-year history of a foreign body sensation in her throat and a six-month history of an intermittently protruding mass in her mouth. Despite numerous consultations and several indirect laryngoscopic examinations, no abnormalities were identified, resulting in a delayed diagnosis. Dynamic videolaryngoscopy performed during the gag reflex revealed a smooth pedunculated mass protruding into the oral cavity from the right side. Imaging studies showed dilatation of the upper and middle esophagus along with a long intraluminal soft tissue mass. Flexible upper gastrointestinal endoscopy revealed a large polypoidal lesion with a long pedicle originating from the right lateral wall just above the cricopharynx and extending into the esophagus. Surgical treatment was carried out using a combined approach involving tracheostomy, direct hypopharyngoscopy, and left lateral pharyngotomy, allowing safe identification, ligation, and complete removal of the mass. Histopathological analysis confirmed the presence of a giant fibrovascular polyp. The postoperative recovery was uneventful, and the patient remains symptom-free during follow-up. This case emphasizes the diagnostic challenges associated with giant fibrovascular polyps and highlights the importance of dynamic assessment and prompt surgical intervention to prevent life-threatening complications.