# 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.

## Key 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.