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Competing Interests: Disclosure Both authors disclosed no financial relationships. Commentary In the past decade there has been significant advancement and research to help refine endoscopic resection techniques for precancerous and cancerous GI lesions. This case highlights the importance of understanding the postresection healing process and identification of benign and malignant lesions at previous resection sites. Not all post-ESD defects heal into homogeneous and flat epithelized scars. The development of aberrant and protuberant nodules in post-ESD scars creates concern for neoplastic recurrence. After curative gastric ESD, ≤10% of scars can have a nodular or polypoid appearance, an entity described as PNS. This is more frequently observed in mucosal resections or dissections performed in the gastric antrum and may have an association with the use of histamine-2 receptor antagonists and proton pump inhibitors during the healing phase. Biopsy specimens taken from these scars show regenerative mucosa without neoplastic recurrence, and in most cases the nodular granulation tissue disappears after scarring without any long-term clinical implications. It is important for endoscopists to recognize such benign post-ESD scars and to avoid unnecessary closer follow-up care or aggressive reinterventions. Muhammad Arslan Baig, MD, Interventional Gastroenterologist, Clinical Assistant Professor of Medicine, University of Texas Health Sciences Center at Tyler, Tyler, Texas, USA Amy Tyberg, MD, FASGE, FACG, Associate Editor for Focal Points