Question: A 51-year-old man was referred to our hospital, presenting with a history of dysphagia for 3 months. Besides a history of smoking for 30 years, no abnormal symptoms or medical history were recorded, such as hypertension or weight loss. Laboratory examinations were also normal. Under gastroscopy, a 1.2 × 0.6-cm submucosal tumor (SMT) was found (Figure A, arrow). Interestingly, another horseshoe-shaped apophysis was located just near the lesion, occupying almost two-thirds of the circle of the esophagus (Figure A, arrowhead).