Plain gastroscopy does not determine the nature of the submucosal esophageal mass. Ultrasound gastroscopy is usually required to determine the nature of the lesion initially, and pathology is ultimately required to determine it. For now, it is advisable to perform ultrasound gastroscopy to determine the nature of the lesion before deciding on the next step of treatment. Smooth muscle tumors are more common in submucosal esophageal masses. If they originate in the mucosal muscle layer, they can be removed gastroscopically and do not require surgical treatment. If the origin is in the intrinsic muscle layer of the esophagus, surgical treatment is required, and thoracoscopic treatment is preferred, which is less damaging and faster healing than general surgical treatment.