History of epigastric discomfort and anemia.
CT Abdomen (selected images)
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In the pyloric segment of the stomach, there is a low attenuation polypoid intraluminal mass with well-defined margins and a smooth surface. Contrast enhancement is slightly heterogeneous, but no calcification, necrosis, or haemorrhage is seen. There is no evidence of extra-gastric invasion or gastric obstruction.
The patient has been referred for gastroscopy. Biopsy and further surgery confirmed a gastric leiomyoma. Its known that most leiomyomas are asymptomatic, but eventual ulceration may cause pain and signs of gastrointestinal bleeding. On imaging, this tumour is normally characterised as:
- solitary mass
- usually smaller than 3 cm
- location: distal body of the stomach or fundus
The main differential diagnosis on imaging is made with a gastric GIST, which is much more common.