Open Gastrostomy of a Gastric Leiomyoma Proximal to the Gastroesophageal Junction: A Case Report

TL;DR

A 75-year-old woman with a gastric leiomyoma near the gastroesophageal junction presented with upper GI bleeding and was successfully diagnosed and treated.

Contribution

This case report highlights the presentation and management of a gastric leiomyoma in a rare location.

Findings

A gastric leiomyoma near the gastroesophageal junction was diagnosed via open gastrostomy and biopsy.

Leiomyomas should be considered in the differential diagnosis for upper gastrointestinal bleeding.

The patient's symptoms resolved after excisional biopsy and treatment.

Abstract

Gastric leiomyomas are benign, submucosal tumors found incidentally on unrelated imaging or during autopsy. The majority of leiomyomas are asymptomatic; however, patients can develop central ulcerations on the lesions leading to upper gastrointestinal (GI) bleeding. A 75-year-old female, with a past medical history of hypertension, hyperlipidemia, and a cerebrovascular accident, presented with complaints of melena, near-syncope events, lightheadedness, weakness, and hematemesis. A computed tomography (CT) of the abdomen with contrast found a heterogeneous low-attenuation mass of 4×4×3 cm3 within the gastric fundus and near the gastroesophageal (GE) junction. After an open gastrostomy and excisional biopsy, the mass was identified as a leiomyoma. This case report reviews the presentation, diagnostic assessments, and treatment of a gastric leiomyoma in a complex location proximal to the gastroesophageal junction. Gastric leiomyomas should be considered as a differential diagnosis for patients presenting with an upper gastrointestinal bleed.

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