Mucosa-Preserving Endoscopic Submucosal Excavation Followed by Defect Closure Using a Through-the-Scope Twin Clip for a Giant Rectal Gastrointestinal Stromal Tumor

<p dir="ltr">A 59-year-old women presented to our hospital with a 30mm submucosal rectum tumor.Pelvic computed tomography (CT) revealed a rounded mild abnormal enhancement on the right lateral wall of the lower rectum.The lesion showed internal punctate calcifications with no surrounding lymphadenopathy, findings consistent with either a stromal tumor or a schwannoma.Endoscopic ultrasound revealed the lesion originating from the muscularis propria with intraluminal growth,demonstrating firm consistency on elastography.Therefore, a mucosa-preservingendoscopic submucosal excavation(ESE) was performed to completely remove the lesion.A submucosal injection was performd,followed by a mucosal incision along the apical margin of the tumor to achieve adequate exposure.The tumor was completely resected using a combination of forward and retroflexed endoscopic views.</p>