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Epidemiological data are scant and imprecise, but approximately one in every 300 routine endoscopies reveals a bulging of the gastrointestinal wall covered by smooth mucosa of normal appearance 1 (Figure 1). Such a finding, though usually incidental, raises questions of clinical significance: Does the bulging represent a pathology that is real or only a figment of the endoscopist's imagination? Does it result from pressure on the wall from the outside, and if so, what is the compressing structure? Or is there a tumor deep in the wall, under the smooth surface of the overlying mucosa, a so-called submucosal tumor (SMT)? Finally, and most importantly, what is the risk that the lesion in question is malignant and requires treatment?
Marcin Polkowski (Fri,) studied this question.