Smooth muscle tumors of the stomach

A series of fifty-one smooth muscle tumors of the stomach seen at the Massachusetts General Hospital over a twenty year period is reviewed. Virtually all benign tumors were asymptomatic and were discovered in the course of autopsy or an unrelated operation. Malignant tumors frequently caused symptoms. Contrast studies and endoscopy, although they confirmed the presence of the lesions, were of limited value in differentiating between benign and small malignant tumors preoperatively. Eighty-two per cent of the malignant lesions were well circumscribed, and 57 per cent of patients with gastric leiomyosarcomas survived at least five years after resection. Benign tumors may be treated by local resection, but malignant tumors should be resected widely, with involved adjacent organs if technically feasible.