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

Yıl 2023, Cilt: 22 Sayı: 1, 32 - 37, 30.04.2023

Ersin Gümüş Diclehan Orhan İnci Nur Saltık Temizel

https://doi.org/10.17941/agd.1268799

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

• 1. Adler RH, Carberry DM, Ross CA. Papilloma of the esophagus: association with hiatal hernia. J Thorac Surg 1959;37:625-35.
• 2. Odze R, Antonioli D, Shocket D, et al. Esophageal squamous papillomas. A clinicopathologic study of 38 lesions and analysis for human papillomavirus by the polymerase chain reaction. Am J Surg Pathol 1993;17:803-12.
• 3. Szanto I, Szentirmay Z, Banai J, et al. [Squamous papilloma of the esophagus. Clinical and pathological observations based on 172 papillomas in 155 patients]. Orv Hetil 2005;146:547-52.
• 4. Tou AM, Al-Nimr AO. Esophageal squamous papilloma in children: A single-center case series. J Pediatr Gastroenterol Nutr 2021;72:690-2.
• 5. Mosca S, Manes G, Monaco R, et al. Squamous papilloma of the esophagus: long-term follow up. J Gastroenterol Hepatol 2001;16:857-61.
• 6. Takeshita K, Murata S, Mitsufuji S, et al. Clinicopathological characteristics of esophageal squamous papillomas in Japanese patients--with comparison of findings from Western countries. Acta Histochem Cytochem 2006;39:23-30.
• 7. Syrjanen S, Syrjanen K. HPV-associated benign squamous cell papillomas in the upper aero-digestive tract and their malignant potential. Viruses 2021;13:1624.
• 8. Rebeuh J, Willot S, Bouron-Dal Soglio D, et al. Esophageal squamous papilloma in children. Endoscopy 2011;43(Suppl 2)UCTN:E256.
• 9. Nasr Y, Salgado D, El Demellawy D, et al. Esophageal squamous cell papillomatosis arising in focal dermal hypoplasia in a 3-year-old girl. J Pediatr Gastroenterol Nutr 2018;66:e132-e134.
• 10. Pasman EA, Heifert TA, Nylund CM. Esophageal squamous papillomas with focal dermal hypoplasia and eosinophilic esophagitis. World J Gastroenterol 2017;23:2246-50.
• 11. Yang Q, Stefanovici C, Mujawar Q, et al. Esophageal squamous papilloma in a pediatric patient with Helicobacter pylori gastritis. Pediatr Dev Pathol 2018;21:105-6.
• 12. Inomata S, Aoyagi K, Eguchi K, Sakisaka S. Giant esophageal papilloma. Gastrointest Endosc. 2004;60:430.
• 13. Park SH, Bang BW, Kim HG, Shin YW, Kim L. A case of esophageal squamous papillomatosis. Korean J Intern Med. 2012;27:243.
• 14. Talamini G, Capelli P, Zamboni G, et al. Alcohol, smoking and papillomavirus infection as risk factors for esophageal squamous-cell papilloma and esophageal squamous-cell carcinoma in Italy. Int J Cancer 2000;86:874-8.
• 15. Sablich R, Benedetti G, Bignucolo S, Serraino D. Squamous cell papilloma of the esophagus. Report on 35 endoscopic cases. Endoscopy 1988;20:5-7.
• 16. Ekin N, Bestas R, Cetin A. Clinicopathological characteristics of patients with oesophageal squamous papilloma in Turkey and comparison with the literature data: The largest case series ever reported from Turkey. Int J Clin Pract 2021;75:e14420.
• 17. Singhal S, Baker RD, Khan A, et al. A rare case of esophageal papilloma due to Human papillomavirus with uncommon presentation of dysphagia in a 2-year-old child. Clin Pediatr (Phila) 2016;55:1168-70.
• 18. d'Huart MC, Chevaux JB, Bressenot AM, et al. Prevalence of esophageal squamous papilloma (ESP) and associated cancer in northeastern France. Endosc Int Open 2015;3:E101-6.
• 19. Reynoso J, Davis RE, Daniels WW, et al. Esophageal papillomatosis complicated by squamous cell carcinoma in situ. Dis Esophagus 2004;17:345-7.
• 20. Bongiovanni A, Manti S, Parisi GF, et al. Focus on gastroesophageal reflux disease in patients with cystic fibrosis. World J Gastroenterol 2020;26:6322-34.
• 21. Rosen R, Vandenplas Y, Singendonk M, et al. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 2018;66:516-54.