Squamous cell papilloma of the esophagus: report of 17 cases and review of the literature

The aim of this study is to report our cases of squamous cell papilloma of the esophagus retrospectively, to review the reported literature, and to study the association of papilloma with gastroesophageal reflux disease (GERD) and/or reflux esophagitis. We performed upper digestive endoscopies in 24 190 patients over a 6-year period from January 1998 to December 2003 in our clinic. We report the clinicopathological features of 18 lesions of squamous cell papilloma of the esophagus in 17 patients (0.07%) and reviewed the clinical features of 161 cases in the literature. There were 8 men and 9 women with a mean age of 47.8 years (range 18–82 years). None had a history of malignant disease in the past. We used the Los Angeles classification to show the severity of endoscopic esophagitis. Eleven patients had GERD, including 6 patients with endoscopy-positive esophagitis (55%). Although histological inflammation was found at the lower thoracic esophagus in 4 cases, it was not found at other parts of the esophagus. The mean size of the tumors was 4.3 mm (range, 2–10 mm). The mean distance from the dental ridge was 32 cm (range 20–38 cm). Three cases in the upper, 6 cases in the middle, and 9 cases in the lower esophagus were found. Sixteen patients had a single whitish polypoid lesion and 1 patient had two polypoid lesions at the middle esophagus. Although in 1 papilloma mild atypia was found, in 17 papillomas atypia and carcinoma were not detected. The median duration of follow-up of our cases was 30.6 months (range 2–70 months). During the follow-up period, none of the papillomas showed changes. Although our case and the cases reviewed in the literature were all of benign course in the follow-up period, we should follow them up, combined with reflux esophagitis periodically.