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+A 65-year old female was admitted with progressive dysphagia for 2 months and 5 kg weight loss.
+Her past medical history was significant for osteoporosis treated with calcium lactate tablets, daily, for 5 years.
+Upper gastrointestinal endoscopy described a 4 cm whitish firm mass in the middle esophagus (Fig.1) and a semi-circumferential deep ulcer with irregular borders on the opposite mucosa (Fig.2).
+During endoscopy a pedicle was not identify by handling a polipectomy snare around the esophageal mass.
+Upper gastrointestinal series with gastrografin (Fig.3) revealed an ovoid lacunar image at the distal part of the esophagus esophageal, inhomogeneous, with calcifications and smooth contours.
+During peristalsis the image was mobile and no pedicle was identified.
+The esophageal lumen was enlarged with a diverticula development at the posterior wall.
+Also computer tomography of the thorax excluded a pedunculated tumor, describing an intra-luminal calcified esophageal mass (Fig.4).
+The biopsies obtained from the esophageal ulcerated mucosa revealed inflammatory cells, without malignancy.
+Based on these endoscopic and imagistic results a bezoar was supposed to have been developed in an esophageal diverticula, subsequently with ulcerated mucosa.
+The esophageal mass was removed with an endoscopic snare in one piece, as the fragmentation was not physically possible.
+The macroscopic appearance revealed a 4 cm, globular mass, heterogeneous, dense, whitish, in places with harsh yellow foci, most likely dystrophic calcification.
+The macroscopic examination on cross section revealed a light gray aspect (fibrous appearance) that includes multiple harsh yellow-orange structures, difficult to section (Fig.5).
+This mass was immersed into trichloracetic acid for decalcification.
+Microscopic examination revealed hyaline fibrous tissue (Fig.6a), stained in green in Tricrom Mason (Fig.6b), with numerous crystalline basophils deposits of minerals, rare fibrocytes and very few vessels.
+The presence of capillary structures, rare fibroblasts and collagen fibers brought in discussion a mesenchymal originating mass, most likely a fibrovascular polyp.
+A definitive histological diagnosis was not possible, as the pedicle was not identified, but the presence of the connective tissue suggested the previous presence of a pedicle into the lesion.
+The long term calcium tablets intake might explain the calcification process developed into the vascular-connective tissue, revealed on histology by the numerous crystalline basophils deposits of minerals.
+One month later the patient was asymptomatic.
+The endoscopy did not revealed an enlarged esophagus, the appearance of the esophageal mucosa was normal (without ulcerations) and no diverticula was identified.
+No motility disturbances were found on esophageal manometry.
+Based on the clinical course, the history of calcium lactate intake and histological appearance a diagnosis of an esophageal benign mesenchymal originating mass (most probably a fibrovascular polyp) auto-amputated and calcified was formulated.