Kistik fibrozis tanılı bir çocuk hastada saptanan özofageal skuamoz hücreli papillom: Nadir ve insidental bir endoskopik bulgu

Öz

Özofageal skuamoz hücreli papillom, özofagusun nadir görülen bir epitel lezyonudur. Çocuklarda özofageal skuamoz hücreli papillom ile ilgili epidemiyolojik veriler kısıtlıdır ve birkaç vaka raporundan oluşmaktadır. Özofageal skuamoz hücreli papillomun etiyolojisi belirsizliğini korusa da, özofagus mukozasının kimyasal/mekanik tahrişe bağlı gösterdiği hiper-rejeneratif yanıt ve human papillomavirus enfeksiyonu en olası nedenler olarak öne sürülmüştür. Kistik fibrozisli ve kronik dispepsisi olan 14 yaşında bir kız çocuğunda alt özofagus sfinkterine yakın lokalizasyonda 0.5 x 0.5 cm boyutlarında, sesil, multilobüle, beyazımsı ve verrüköz polipoid lezyon çıkarıldı. Histolojik olarak lezyonun benign skuamoz papillom olduğu gösterildi. Hastanın gastroözofageal reflü düşündüren dispeptik semptomları, lezyonun çıkarılması ve anti-asit tedavi sonrası düzeldi. Özofageal skuamoz hücreli papillom, üst endoskopide insidental olarak saptanan bir bulgudur. Distal özofageal yerleşimli papillomlardan gastroözofageal reflü hastalığı sorumlu olabilir. Çocuklukta nadir görülmesi nedeniyle, yönetimi ve takibiyle ilgili rehber önerileri yoktur. Malignite potansiyeli konusundaki belirsizlik nedeniyle mümkün olduğunda çıkarılmalıdırlar.

Anahtar Kelimeler

• Skuamoz papillom
• özofagus
• gastroözofageal reflü
• kistik fibrozis
• özofagogastroduodenoskopi
• dispepsi

Esophageal squamous cell papilloma in a child with cystic fibrosis: A rare incidental endoscopic finding

Öz

Esophageal squamous cell papilloma is an uncommon epithelial lesion of the esophagus. Epidemiological data regarding esophageal squamous cell papilloma in children is scarce and consists of few case reports. Although the etiology of esophageal squamous cell papilloma remains unclear, chemical/mechanical irritation induced hyper-regenerative response of esophageal mucosa and human papillomavirus infection have been suggested as most probable causes. A case of a 14-year-old girl with cystic fibrosis and chronic dyspepsia had a 0.5 x 0.5 cm sessile, multilobulated, whitish and verrucous polypoid mass close to the lower esophageal sphincter removed. Histologically, a benign squamous papilloma was confirmed. Her dyspeptic symptoms suggestive for gastroesophageal reflux resolved after papilloma removal and anti-acid treatment. Esophageal squamous cell papilloma is an incidental finding at upper endoscopy. Gastroesophageal reflux disease may be responsible for distally localized papillomas. Due to its rarity in childhood, there are not any well-established management and surveillance guidelines. Esophageal squamous cell papilloma should be removed, when possible, because of the ambiguity about its malignant potential.

Anahtar Kelimeler

• Squamous papilloma
• esophagus
• gastroesophageal reflux
• cystic fibrosis
• esophagogastroduodenoscopy
• dyspepsia

Kaynakça

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