Post written by Hayato Yamaguchi, MD, PhD, from the Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Our video case describes successful resection of a giant pedunculated pharyngeal liposarcoma in the esophagus by endoscopic submucosal dissection using grasping forceps. Hypopharyngeal and esophageal liposarcomas are very rare, and these tumors are mainly diagnosed as pedunculated submucosal tumors. Mobile pedunculated tumors of the hypopharynx have the risk of causing airway obstruction and should hence be extracted. We here report a rare case of a patient in whom endoscopic submucosal dissection (ESD) using grasping forceps was performed for a giant pedunculated pharyngeal liposarcoma in the esophagus. The patient was a 75-year-old man who presented to our hospital owing to difficulty swallowing. Upper gastrointestinal endoscopy and computed tomography displayed a 11-cm large pedunculated submucosal tumor with a smooth surface on the posterior hypopharyngeal wall, which extended intraluminally to the middle esophagus.
Our present case demonstrates that ESD may be useful for making definitive diagnoses and for the treatment of pharyngeal pedunculated submucosal tumors. The countertraction method using the orally inserted grasping forceps enables pharyngeal ESD to be performed safely and easily as a minimally invasive treatment.
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