Evaluation and Endoscopic Management of Esophageal SMT

Submucosal tumors (SMTs) are those that originate from cells constituting the submucosal layer and the muscularis propria and are covered by normal mucosa. Esophageal SMT is a rare disease accounting for less than 1% of overall esophageal tumors, but recent wide use of endoscopy has led to a rapid increase in incident cases of such tumors. Esophageal SMTs are positive in 90% or more of the cases, but the possibility of malignancies, such as gastrointestinal stromal tumor (GIST) and malignant leiomyosarcoma, still exists. Therefore, patients undergo a resection in the presence of symptoms or the possibility of a malignant tumor. For resection of esophageal subepithelial tumor, surgical resection was the only option available in the presence of the possibility of malignancy, but minimally invasive surgery by endoscopic resection is becoming more preferable to surgical resection with the development of endoscopic ultrasonography, endoscopy techniques and devices. This article will discuss methods of diagnosing esophageal SMT and a variety of therapeutic endoscopy.