Mai WJ, Miao W, Ma YM, Zhou HH, Yuan S. Submucosal tunnel docking endoscopic resection for a large gastroesophageal junction leiomyoma: A case report. World J Gastrointest Oncol 2026; 18(8): 121073 [DOI: 10.4251/wjgo.121073]
Corresponding Author of This Article
Shuai Yuan, PhD, Endoscopy Center, Xiaolan Clinical Institute of Shantou University Medical College, No. 65 Jucheng Road, Zhongshan 528415, Guangdong Province, China. yuanshuaishuai888@126.com
Research Domain of This Article
Gastroenterology & Hepatology
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case-report
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Mai WJ, Miao W, Ma YM, Zhou HH, Yuan S. Submucosal tunnel docking endoscopic resection for a large gastroesophageal junction leiomyoma: A case report. World J Gastrointest Oncol 2026; 18(8): 121073 [DOI: 10.4251/wjgo.121073]
World J Gastrointest Oncol. Aug 15, 2026; 18(8): 121073 Published online Aug 15, 2026. doi: 10.4251/wjgo.121073
Submucosal tunnel docking endoscopic resection for a large gastroesophageal junction leiomyoma: A case report
Wei-Jian Mai, Wang Miao, Ya-Mei Ma, Hai-Hua Zhou, Shuai Yuan
Wei-Jian Mai, Wang Miao, Ya-Mei Ma, Hai-Hua Zhou, Shuai Yuan, Endoscopy Center, Xiaolan Clinical Institute of Shantou University Medical College, Zhongshan 528415, Guangdong Province, China
Author contributions: Mai WJ and Yuan S designed the research; Mai WJ and Ma YM collected the data and performed the analysis; Mai WJ prepared the manuscript draft; Yuan S supervised the work and critically revised the manuscript; Miao W and Zhou HH provided research support and assisted with the revision. All authors read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report and its accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest. No financial or personal relationships with any individuals or organizations could inappropriately influence the work reported in this case report. The research received no external funding, and the authors alone are responsible for the content and writing of the manuscript.
CARE Checklist (2016) statement: The authors have completed the CARE Checklist (2016) for this case report and confirm that the manuscript adheres to its guidelines. A completed copy of the CARE Checklist is available as supplementary material.
Corresponding author: Shuai Yuan, PhD, Endoscopy Center, Xiaolan Clinical Institute of Shantou University Medical College, No. 65 Jucheng Road, Zhongshan 528415, Guangdong Province, China. yuanshuaishuai888@126.com
Received: March 16, 2026 Revised: April 26, 2026 Accepted: June 15, 2026 Published online: August 15, 2026 Processing time: 144 Days and 21.8 Hours
Abstract
BACKGROUND
Submucosal tumors (SMT) at the gastroesophageal junction present challenges for endoscopic treatment, particularly when they are large, irregularly shaped, or originate from deep layers. Achieving complete resection while preserving cardia function remains a key objective in the clinic.
CASE SUMMARY
A 43 year old female patient was found to have a SMT in the gastric fundus during a routine health checkup. Endoscopy revealed a lesion involving three quarters of the cardia. Endoscopic ultrasound suggested a hypoechoic lesion originating from the muscularis propria. The patient underwent submucosal tunnel docking endoscopic resection (SDER). An esophageal submucosal tunnel was first created to dissect the tumor base, followed by retroflexed endoscopic dissection in the stomach. The tumor was completely removed without bleeding or perforation. The resected specimen measured 8.0 cm × 2.5 cm × 1.5 cm. Postoperative pathology and immunohistochemistry confirmed a gastric leiomyoma.
CONCLUSION
SDER proved to be a feasible technique for this large, irregularly shaped leiomyoma at the gastroesophageal junction, achieving complete tumor removal without short term complications. However, the follow-up period was limited to 30 days; longer follow-up is required to fully establish its safety and effectiveness.
Core Tip: Submucosal tunnel docking endoscopic resection (SDER) is a modified technique for treating a large submucosal tumor (SMT) at the gastroesophageal junction. We report a case of an 8-cm gastric leiomyoma involving three-quarters of the cardia. SDER was performed by first creating an esophageal submucosal tunnel to dissect the tumor base, followed by retroflexed endoscopic dissection in the stomach. The tumor was completely resected without bleeding or perforation. This technique may provide a safe and effective option for large, irregularly shaped SMTs at this challenging location.
