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Submucosal tunneling endoscopic resection of a giant esophageal leiomyoma

      Submucosal tunneling endoscopic resection (STER) for removal of upper GI tumors arising from the muscularis propria (MP) has been demonstrated to be effective and safe. In this video, we demonstrate the feasibility of STER for a giant, symptomatic esophageal leiomyoma and the closure of a large mucosal entry. A 53-year-old woman was seen with a 2-month history of progressive dysphagia and chest pain. A chest CT scan revealed a 6 × 2.8 × 2.2-cm esophageal mass adjacent to the descending aorta and azygos vein (Fig. 1; Video 1, available online at www.giejournal.org). EUS-guided core biopsy confirmed the diagnosis of leiomyoma.
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      Figure 1A, The lesion (arrow) can be seen adjacent to the descending aorta. B, A hypoechoic mass originating from the muscularis propria layer of the esophagus on radial EUS. C, The lesion within the tunnel after dissection off the muscularis propria. D, A large empty tunnel after retrieval of the lesion.
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