Answer: Giant fibrovascular polyp

Histology: Sections of this 6.5 cm filiform mucosal covered structure show benign fibroconnective tissue that is entirely covered by benign non-keratizing squamous epithelium. No atypical cells are noted.

Discussion: Giant fibrovascular polyps of the hypopharynx similar to giant fibrovascular polyps of the esophagus are filiform structures that can cause airway/esophagus obstruction. They are often regurgigated and may appear in the oral cavity. They are covered by benign squamos mucosa and have fibroconnective tissue core that is variably vascular and contains adipose tissue. A small subset of cases may show adipocyte atypia mimicking an atypical lipomatous tumor. Complete removal is therapeutic.