Leiomyoma of the Stomach

 

This is the 2nd most common benign gastric tumor, after gastric polyp. Its most usual location is the body of the stomach (39%) and the antrum (26%). Most of these lesions are submucosal (60%) growing intraluminally while 35% are exophytic subserosal.

 

The mass is usually ovoid with smooth margin and surface and average size about 4,5cm. Ulcerations occur in about 50% of cases.

 

The “iceberg phenomenon” refers to the presence of large extraluminal tumor in submucosal growth.

 

Clinical features may include haemorrhage (acute or chronic), obstruction, perforation and fistulization, malignant degeneration.

 

Radiologic features

 

 

Submucosal lesions characteristically produce a smooth buldge into the lumen with margins that form an obtuse angle with the normal wall. When the growth is predominantly exophytic the tumor may drag on the gastric wall to produce a niche.

 

Differential diagnosis

 Leiomyosarcoma

 

The difficulty in differentiating leiomyomas from leiomyosarcomas and because of their tendency to ulcerate, tumors larger than 3 cm are generally removed surgically.

 

 

References

1. David Sutton: Textbook of Radiology and Imaging. International Edition reprint 2000,          pp 846

 

2. Wolfgang Dahert: Radiology review manual 5th. Edition pp 840