Endoscopic Look at The Papilloma of the Middle Third of the Esophagus

Papilloma of the middle third of the esophagus. Esophageal squamous papilloma (ESP) is a relatively rare, benign, squamous epithelial tumor, which is generally small, single, round and elevated sessile lesions with smooth or rough surfaces. Two etiological factors of ESPs have been posited. One is hyper-regenerative response of the mucosa to chemical and mechanical irritation such as minor trauma, chronic food impaction, alcohol consumption, cigarette smoking, previous gastroesophageal surgery and gastroesophageal reflux diseases (GERDs) The mucosal irritant theory is clinically supported by the high prevalence of ESPs in the lower esophagus, the site most severely affected by GERDs. The other is human papilloma virus (HPV) infection. Since Syrjanen et al. demonstrated the presence of HPV antigens in ESPs, HPV infection has been considered one of the etiological factors of ESPs, although the exact pathogenetic importance of the HPV is not yet clear.