Figure 1

A gastric subepithelial tumor originating from the muscularis propria layer was resected by the modified ESD with enucleation. a. Endoscopic view of the gastric subepithelial tumor at gastric high body. b. Endoscopic ultrasonography (EUS) revealed an inhomogeneous hypoechoic tumor arising from the muscularis propria layer. c. A precut and longitudinal incision of the mucosa. d. Lateral dissection with an insulated-tip knife 2 exposing an encapsulated tumor. e. A slight dumbbell-shaped tumor was enucleated. f. No visible residual tumor at ulcer base. g. A whitish scar was shown 2 months after dissection. h. EUS revealed mild thickening of the second layer and no recurrent tumor in the muscularis propria layer.