Gastric leiomyoma

Case contributed by Dr Bruno Di Muzio

Presentation

History of epigastric discomfort and anemia.

Patient Data

Age: 75 years
Gender: Male

CT Abdomen (selected images)

CT

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 hemorrhage is seen. There is no evidence of extra-gastric invasion or gastric obstruction. 

Case Discussion

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 tumor is normally characterized 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. 

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