Gastric leiomyosarcoma mimicking hepatocellular carcinoma 

Gastric leiomyosarcoma is an extremely rare malignancy with an aggressive course. Complete excision of the tumour with adjuvant therapy is a curative option. The patient presents with non-specific upper gastrointestinal symptoms. Preoperative biopsy and immunostaining with endoscopic ultrasound guidance is the most accurate tool for diagnosis. We present here a case of a middle-aged man, presenting with upper abdominal heaviness and a lump which progressed rapidly in size over a few weeks, associated with appetite and weight loss. Radiographic evaluation was suggestive of a large tumour of the left lobe of the liver, possibly hepatocellular carcinoma, due to raised protein induced by vitamin K absence-II levels. Intraoperatively, it turned out to be of gastric origin, in relation to the liver. .