Submucosal Tunnel Endoscopic Resection of Giant Leiomyoma of the Esophagus Combined with Circular Arc Incision and 3D Volume Rendering.

Esophageal leiomyoma is a common benign tumor of the esophagus. Traditionally, surgical resection is performed for large lesions. In this case, a 19-year-old male patient with a GEL underwent three-dimensional volume rendering to assess the surrounding structures, followed by submucosal tunneling and resection (STER). A modified arc-shaped mucosal incision was designed to provide sufficient exposure for dissection and complete removal of the lesion. Postoperative pathology confirmed leiomyoma. The patient resumed oral intake on postoperative day 2 and was discharged on day 5. STER creates a submucosal tunnel between the mucosal and muscular layers of the digestive tract and is mainly used for removing small esophageal and cardia submucosal tumors originating from the muscularis propria. It offers several advantages, including a short operation time, minimal trauma, rapid recovery, and no visible scars. In this case, STER was successfully applied to remove a large lesion, indicating that endoscopic treatment of GEL is both safe and feasible. However, further experience is required to evaluate its long-term efficacy.