Management of gastrointestinal subepithelial lesions: An answer to the conflicting opinions

Subepithelial lesions formerly known as subepithelial tumors are incidentally discovered protrusions throughout the gastrointestinal tract with normal overlying mucosa. Studies related to the diagnosis and methods of therapy are limited due to the low incidence and low malignant potential of these lesions. They are commonly originating from the second, third and fourth layers (muscularis mucosa, submucosa and muscularis propria) of gastrointestinal wall. They are reported to be more prevalent in stomach and esophagus than small intestine and colon. Subepithelial lesions located in the stomach and duodenum are more prone to malignancy than the lesions in the esophagus. Despite the presence of different strategies in the management of subepithelial lesions based on their size and location, there is still not a unique consensus on the issue. In this review we have attempted to introduce the most practical approach to the management of gastrointestinal subepithelial lesions based on current guidelines.