Esophageal Pedunculated Polyp: Symptoms, Diagnosis & Treatment Options

A pedunculated esophageal polyp is a mucosal projection on a stalk (peduncle), usually benign (fibrovascular, inflammatory, hyperplastic). Rarely: adenomatous (premalignant) or squamous cell carcinoma.

Symptoms (Size/Location Dependent)

• Dysphagia (mechanical obstruction).
• Globus sensation.
• Regurgitation, heartburn (if near LES).
• Chest pain (esophageal spasm).
• Bleeding (ulcerated surface) → hematemesis/melena.
• Asymptomatic (incidental on endoscopy).

Diagnosis

• Upper endoscopy (EGD): Visualizes polyp, stalk, mobility.
• Biopsy: Mandatory—rules out dysplasia/carcinoma.
• EUS: Assesses wall layer origin, depth, lymph nodes.

Treatment

• Endoscopic resection: Snare polypectomy (pedunculated), EMR/ESD (sessile/large). En bloc preferred.
• Surgery: If malignant invasion, failed endoscopic resection, or perforation.
• Surveillance: If benign, small, asymptomatic—interval endoscopy per guidelines.

Follow-Up

Pathology dictates surveillance. Benign: 1–3 years. Dysplasia/cancer: multidisciplinary, per oncology guidelines.