67 y/o male with vague abdominal pain and indigestion was referred for UGI. The selected UGI images shown above demonstrate a solitary, umbilicated/ulcerated, gastric mass which has smooth borders and an appearance that suggests a submucosal location. Diagnostic considerations include: leiomyoma, leiomyosarcoma, leiomyoblastoma, lymphoma, metastatic disease (esp. melanoma), and other rare mimics. Resection of the mass revealed a leiomyoma. Smooth muscle tumors are the second most common benign gastric mass after adenomatous polyps. Leiomyomas may be submucosal, intramural or subserosal. Usually they are solitary, rarely multiple. Pain and GI bleeding are common presenting symptoms. The umbilication observed is secondary to central necrosis of the mass as it protrudes into the gastric lumen.
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