Gastric Leiomyoma: Can It Turn Cancerous?

Gastric leiomyoma is a type of benign tumor that originates from the smooth muscle layer of the stomach wall. It accounts for approximately 60% to 70% of all benign gastric tumors and typically measures less than 5 cm in diameter. These tumors are most commonly found in the gastric body and fundus and can be classified into three types: intragastric, intramural, and extragastric. While they can occur at any age, they are rarely seen in men under the age of 40.

Most gastric leiomyomas are asymptomatic and are often discovered incidentally during gastrointestinal imaging or endoscopic examinations. However, when the tumor grows larger, patients may experience abdominal discomfort, dull pain, or even detect an abdominal mass. These symptoms usually appear when the tumor reaches a significant size and begins to exert pressure on surrounding tissues.

Although gastric leiomyoma is a benign condition and not cancerous by nature, there is a small possibility that it may undergo malignant transformation under certain conditions. The exact probability of such a transformation remains unclear, but clinical evidence suggests that the risk is very low. Nevertheless, it is crucial for physicians to differentiate gastric leiomyoma from gastric leiomyosarcoma, which is a malignant smooth muscle tumor with a much poorer prognosis.

When there is uncertainty in diagnosis, certain clinical features may suggest a more aggressive tumor type. These include a tumor size greater than 5 cm, infiltrative growth patterns, presence of local metastases, or ulceration on the gastric mucosa overlying the tumor. In such cases, surgical intervention following the principles used for treating leiomyosarcoma should be considered.

Patients diagnosed with gastric leiomyoma generally have a favorable prognosis following appropriate treatment. However, those with gastric leiomyosarcoma face a more challenging outlook, which underscores the importance of accurate diagnosis and timely management. Regular follow-up and monitoring are recommended for all patients to ensure early detection of any potential recurrence or complications.