
Subepithelial tumors (SETs) of the upper gastrointestinal tract are generally uncommon with an incidence of about 0.4% of all routine endoscopic examinations. Gastric SETs have a malignancy rate of approximately 50%, in contrast, esophageal SETs are usually benign leiomyomas and only 1%-3% harbor malignancy. Generally, SETs are asymptomatic and found incidentally. However, larger SETs can cause dysphagia(sensation of food sticking with swallowing), chest pain, regurgitation and bleeding. Traditionally, excision of symptomatic SETs has been performed with open surgical, laparoscopic or thoracoscopic techniques. These procedures are invasive, associated with significant health-care cost and morbidity. With the introduction of POEM, the submucosal tunneling technique has been subsequently applied for Per-oral endoscopic tumor (POET) resection by Dr. Inoue in 2012. The technique has allowed SETs to be removed from the esophagus and gastric cardia, safety and effectively. Since its first description, multiple series have been published supporting its safety and efficacy.