Esophageal Pyogenic Granuloma: Endosonographic Findings and Endoscopic Treatments
A 58-year-old man underwent upper endoscopy as part of a medical check-up. The endoscopic findings showed the presence of a polypoid lesion in the lower esophagus. The patient was asymptomatic, and physical examination showed unremarkable findings. The upper endoscopy showed a 1-cm polypoid mass that was located just above the esophagogastric junction (). The mass had a smooth surface and was covered with white exudates; it did not exhibit cushion sign. Endoscopic ultrasonography (EUS) showed that the lesion was homogeneously hyperechogenic (), had clear margins, and was located in the submucosa. Endoscopic and EUS findings suggested possibility of an inflammatory lesion such as inflammatory fibrinoid polyp. The patient wanted to remove the tumor strongly and then endoscopic resection was planned without biopsy. For endoscopic resection, a saline solution was injected to lift the lesion. Next, we performed endoscopic mucosal resection (EMR). The lesion was completely resected without complications (). Histological examination showed edematous granulation tissue containing numerous capillaries with acute and chronic inflammatory cell infiltration (). These histological findings were indicative of pyogenic granuloma. Recurrence was not observed during the follow-up endoscopy performed 6 months later.