Gastric Leiomyoma Diagnosis: Key Methods And Insights

Gastric leiomyoma is a benign tumor that originates from the smooth muscle layers of the stomach, most commonly arising from the circular or longitudinal muscle layers, and less frequently from the muscularis mucosae. These tumors are predominantly found in the gastric fundus and body, with a higher incidence on the lesser curvature compared to the greater curvature, and more frequently located on the posterior wall than the anterior wall. The clinical presentation varies depending on the tumor's location, size, growth pattern, and whether complications are present.

Small leiomyomas measuring less than 2 cm typically do not produce symptoms. However, larger tumors may lead to complications such as gastrointestinal bleeding, abdominal pain, bloating, or the presence of an abdominal mass. Among these, gastrointestinal bleeding is the most commonly observed symptom. A range of diagnostic tests is available to detect gastric leiomyoma, including complete blood count (CBC), fecal occult blood test, histopathological analysis, X-ray imaging, abdominal ultrasound, endoscopic ultrasound, computed tomography (CT) scan, and gastroscopy.

During gastroscopy, a spherical, elevated lesion may be observed. The overlying mucosa appears stretched, smooth, and has a similar color to the surrounding mucosa. In some cases, ischemic or necrotic ulcers may develop at the tumor's apex. A definitive diagnosis often requires histological examination of biopsy samples.

Clinicians typically suspect gastric leiomyoma when patients present with symptoms like abdominal discomfort or a palpable mass. Confirming the diagnosis involves correlating clinical findings with laboratory results and imaging studies such as X-rays and gastroscopy. Combining these diagnostic tools helps ensure accurate identification and differentiation from other gastric neoplasms. Endoscopic ultrasound plays a particularly valuable role in assessing the tumor's origin within the gastric wall layers.