dziki przeprowadzonej diagnostyce rozpoznano : nowotwr podcieliskowy przewodu pokarmowego ( gist ) w 1 przypadku , raka gruczoowego przeyku w 1 przypadku oraz 2 torbiele przeyku . intramural esophageal tumors ( iet ) is group of pathological lesions arising from vessels , nerves , smooth muscles , and mucous glands located beneath unchanged mucous membrane of the esophagus . these lesions may develop into both benign and malignant tumors or developmental disorders such as cysts . the most frequent malignant tumors are gastrointestinal stromal tumor ( gist ) and esophageal cancer . benign esophageal tumors are rare and account for less than 1% of esophageal tumors [ 1 , 2 ] . the aim of the study is to present 5 years of experience of diagnostics and treatment of iet . in the years 20112015 eleven patients with iet were treated in our clinic : 6 males and 5 females , aged between 28 and 65 years ( mean age : 52 ) . every patient was diagnosed by means of computed tomography of the chest and gastroscopy . computed tomography ( ct ) scan revealed various sized tumors ( 310 cm ) located in the esophagus . in 1 case the lesion was located in the upper esophagus , in 3 cases the middle esophagus and in the other 7 cases the lower esophagus ( fig . 1 ) . gastroscopy revealed unchanged mucous tissue elevated by an intramural lesion . in all cases an endoscopic ultrasound ( eus ) one patient was diagnosed with gist and 1 with esophageal cancer , whereas in the other cases biopsy results were nondiagnostic . in those cases positron emission tomography ( pet ) was conducted , but the results also did not establish a final diagnosis ( tab . i ) . intramural esophageal tumors  location , size , diagnosis and treatment 
 a  gastrointestinal stromal tumor of the esophagus , b  schwannoma of the esophagus the patient with gist was treated with partial resection of the esophagus using the lewis - tanner technique . the patient with esophageal cancer was treated with transhiatal excision of the esophagus using the orringer technique . in the other cases with benign lesions ii ) . when the diagnosis of malignant tumor was established , the patient was treated with adjuvant chemotherapy . introduction of new techniques of chest imaging enabled more frequent diagnosis of intramural lesions of the esophagus . immunohistochemical examination allowed these lesions to be differentiated . two percent of all esophageal tumors are leiomyomas . they are localized mostly intramurally and can reach considerable sizes [ 24 ] . over a half of all patients in this study schwannoma and gist have rarely been diagnosed so far due to great similarity to leiomyoma both in clinical course and imaging [ 2 , 5 ] . esophageal cysts look distinctly different in eus and ct scans than solid tumors ; therefore they are easier to diagnose [ 68 ] . it is believed they originate from epithelial cells forming mucous glands located intramurally [ 1 , 9 ] . major complaints are progressive dysphagia , hemoptysis , dyspnea , and chest pain [ 2 , 6 , 10 , 11 ] . in esophageal cysts occur mainly in adults , less frequently in younger patients [ 6 , 8 ] . malignant lesions are characteristic for people beyond the age of 50 [ 5 , 9 ] . gender has not been associated with frequency of such lesions [ 4 , 5 , 9 , 11 ] . gastroscopy often shows elevation of unchanged esophageal mucosa to esophagus lumen [ 3 , 7 ] . computed tomography allows one not only to precisely localize the tumor but also to determine its structure and size [ 2 , 3 , 10 ] . the majority of iet are located in the lower third of the esophagus [ 35 ] . positron emission tomography is helpful to verify the status of lymph nodes and possible metastases . in our study pet examination provides the most insight into tumor structure and enables one to perform direct biopsy . in cases of suspected cysts , antibiotic prophylaxis is recommended , because of reported mediastinitis after biopsy of the cyst [ 6 , 7 ] . in our study the method of treatment depends on the size , type of tumor , its location and general condition of the patient [ 1 , 3 , 4 ] . benign lesions can be removed by performing enucleation in vats or thoracotomy [ 1 , 3 , 4 , 10 , 13 ] . inability to enucleate or major damage to the esophageal mucosa is an indication for resection of the esophagus . some authors believe that the biopsy of the tumor performed during eus may hinder its later separation from the esophageal mucosa [ 1 , 3 , 13 ] . while some recommend observation of benign tumors up to 5 cm in diameter [ 1 , 3 ] , the majority of authors recommend surgical removal of all lesions ( including cysts ) due to the possibility of their malignant transformation [ 1 , 4 , 13 ] . intramural esophageal tumors are described on the basis of case reports ; therefore generally their natural history is unknown . intramural esophageal tumors are a diverse group of neoplasms , both benign and malignant . in any case of iet
introductionintramural esophageal tumors ( iet ) are located between unchanged mucous membrane and muscularis mucosae . 
 they can be both benign and malignant.aimto evaluate diagnostic and therapeutic difficulties of iet.material and methodsduring the years 20102015 , 11 patients with iet were treated in our clinic . 
 diagnostics included gastroscopy , computed tomography of the chest , endoscopic ultrasound ( eus ) guided fine needle biopsy , and positron emission tomography ( pet ) of the esophagus in cases with no histopathological confirmation.resultsbased on the conducted analysis we diagnosed 1 case of gastrointestinal stromal tumor ( gist ) , 1 case of adenocarcinoma , and 2 cases of esophageal cysts . in another 7 cases radiological images resembled leiomyoma but with no histopathological confirmation . 
 esophagectomy was performed in 2 cases of malignant tumors and 1 case of a large benign tumor . in other cases 
 surgical enucleation of tumors was performed . 
 postoperatively we diagnosed 6 cases of leiomyoma , 1 case of schwannoma , 2 esophageal cysts , 1 case of gist and 1 of esophageal cancer.conclusionsintramural esophageal tumors is a very diverse group of tumors , both malignant and benign . in every case of iet we should seek histopathological conformation . 
 treatment of iet depends on localization , size and histopathological type of lesion .