Rare Hypopharyngeal Polyp Presenting Without Dysphagia: A Case Report

Fibrovascular polyps (FVPs) of the hypopharynx are exceedingly rare benign tumors. This case showcases an incidental finding of a fibrovascular hypopharyngeal polyp discovered during a flexible laryngoscopy secondary to ear pain in a 72-year-old male. The patient reported no associated dysphagia, voice changes, dyspnea, or globus sensation. Imaging studies, including a CT neck scan, MRI, and videofluoroscopic swallow study, revealed a 1.2 x 1.3 x 1.4 cm solid polyp attached to the hypopharynx without extending into the esophagus. The patient underwent a successful endoscopic excision of the pharyngeal polyp with a partial pharyngectomy. The biopsy of the specimen showed squamous mucosa with stromal degeneration, consistent with a benign polyp. This case report describes a rare asymptomatic hypopharyngeal FVP, notable for its small size and lack of typical symptoms like dysphagia. It emphasizes the importance of early identification through a multimodal approach and careful surgical management to prevent potential complications, as complete surgical excision is curative. While dysphagia is the common symptom of FVPs, this case demonstrates that FVPs can present without it, highlighting the need for FVPs to remain in the differential diagnosis, even when found incidentally.