Laparoscopic resection of gastric leiomyoblastoma

Smooth muscle gastric tumors represent 2% of resected neoplasms of the stomach. Clinically, they are often silent and incidentally found at endoscopy or radiologic examination. These tumors can be histologically classified as benign (leiomyoma) or malignant (leiomyoblastoma), but clinical behavior is not strictly related to this classification. When symptomatic, they are present with anemia in 50% of cases due to mucosal ulceration. Surgical removal of the tumor is the accepted therapy, leaving a margin of surrounding free tissue: this treatment can be performed by laparoscopy, usefully associated with gastroscopy. We present one case of a patient with severe anemia due to bleeding from an ulcerated leiomyoblastoma 5 cm in diameter that we resected with combined gastroscopic-laparoscopic technique. We isolated the portion of gastric wall where the mass was located and resected the specimen under gastroscopic control. The postoperative period was uneventful, and the patient recovered promptly with minimal pain and discomfort.