A 53-year-old male with history of alcohol abuse presented with new-onset seizure/syncope, six painless maroon stools, and coffee-ground emesis. The patient admitted to frequent diclofenac use and ketorolac injections. He did not have a history of varices. Vital signs demonstrated tachycardia (heart rate 111 beats/min) and hypotension (79/59 mmHg). Physical exam revealed pale conjunctiva, dry mucous membranes, and maroon colored stool. He was found to be anemic with a hemoglobin of 7.9 G/dL and had an elevated INR of 1.2. He was transfused two units of packed red blood cells and was started on a pantoprazole drip.\nOnce stabilized, initial EGD revealed an island of tissue growth in the mid-esophagus and a bleeding duodenal ulcer that was injected with epinephrine, cauterized with gold probe and clipped. Biopsy of the esophageal lesion was deferred to outpatient follow-up given the severity of the patient's presenting condition. He had no further signs of gastrointestinal bleeding. Two weeks later, a repeat EGD was performed. Biopsies were taken of the stomach mucosa and mid-esophageal mass (see ). Gastric biopsy demonstrated mild chronic gastritis without dysplastic changes or Helicobacter pylori. Esophageal biopsy demonstrated findings consistent with squamous papilloma (see Figures and ).
A 61-year-old female with history of uncontrolled diabetes mellitus type 2 complicated by gastroparesis, prior esophageal dilation, and ileostomy was being evaluated with endoscopy as outpatient for worsening dysphagia. EGD was significant for a small nodule in the proximal esophagus (see ), normal GEJ (gastroesophageal junction), mild gastritis, and normal duodenum. Gastric biopsy demonstrated mild chronic gastritis without dysplastic changes or Helicobacter pylori. Esophageal biopsy demonstrated findings consistent with squamous papilloma.