Rapidly growing esophageal pyogenic granuloma: A case report and review of the literature

Pyogenic granuloma (PG) or lobular capillary hemangioma (LCH) is a benign vascular tumor characterized by rapid growth, nodular hyperplasia, and bleeding propensity. Though common on skin/oral mucosa, esophageal occurrence is rare. We report a 34-year-old male with recurrent acid reflux. Upper endoscopy (July 2022) revealed a 10-mm polypoid lesion above the esophagogastric junction, absent 13 months prior. It was successfully resected via endoscopic mucosal resection (EMR) after submucosal saline injection, with histology confirming esophageal PG (LCH). Our literature review identified and analyzed 21 previous detailed cases. Analysis of 22 total cases shows these lesions predominantly affect Asian males (M:F=19:3; mean age 57.8 ± 14.8 years). Most patients (71.6%) were symptomatic, primarily with dysphagia or gastrointestinal bleeding. Nearly half (50.0%) occurred in the lower esophagus, averaging 11.5 ± 6.2 mm in size. Over 50% appeared as reddish, exudate-covered nodules, typically pedunculated or semi-pedunculated. EMR effectively managed most cases. This report highlights esophageal PG's potential for rapid growth and supports EMR's diagnostic/therapeutic efficacy, underscoring the importance of recognizing this rare entity for appropriate management.