Coexisting achalasia and leiomyoma misdiagnosed as a submucosal tumor, successfully treated by simultaneous peroral endoscopic myotomy and submucosal tunneling endoscopic resection in the same tunnel.

Peroral endoscopic myotomy (POEM) is a safe and effective method in the treatment of achalasia. Meanwhile, submucosal tunneling endoscopic resection (STER) is a common endoscopic method for the treatment of submucosal tumors (SMT) in the upper digestive tract. However simultaneous POEM and STER for coexisting achalasia and esophageal SMT is rarely reported. A 40-year-old woman underwent esophagoscopy after dysphagia and vomiting for 20 years. The protruding submucosal lesion with normal overlying mucosa was found in the lower part of the esophagus, nearing cardia. Considering the persistent swallowing discomfort and vomiting symptoms, the patient underwent esophageal manometry and barium esophagram, and was finally diagnosed as achalasia with esophageal submucosal tumor. Finally, POEM and STER were performed simultaneously on the patient in the same tunnel. The patient was followed up for 4 months without recurrence or complaints. We herein report a case of achalasia with esophageal leiomyoma who underwent POEM and STER in the same tunnel to remove the mass and relieve the symptoms.