Nonepithelial tumors of the stomach--gastric leiomyomatous tumors: a clinical review

Gastric nonepithelial tumors of clinical significance are infrequently encountered. These tumors make up less than 3 percent of all gastric tumors and are predominantly composed of growths that derive from the gastric smooth muscle. The malignant nature of those leiomyomatous tumors encountered might be obvious by virtue of liver or peritoneal spread or organ invasion at the time of surgery. When this is not the case, a high frequency of mitotic figures and cell necrosis on histologic analysis, while not without exception, correlates best with malignant potential.Hemorrhage, acute or chronic, features prominently as a presenting symptom. The upper gastrointestinal series often suggests the correct diagnosis. The tumors, unlike carcinomas, exhibit little tendency to lateral mucosal and submucosal spread and to lymph node metastasis; consequently, appropriately conservative gastric resectional procedures generally suffice for treatment. Currently, surgery appears to be the only useful modality for the treatment of primary, as well as recurrent, disease.