Gastric wall cyst associated with gastric leiomyoma: A rare case Reprot.

A Case Report

Abstract

Background: Gastric wall cyst is a rare, benign gastrointestinal lesion that can be challenging to diagnose preoperatively because of its nonspecific clinical presentation and imaging features. This condition is rarely associated with gastric leiomyoma, making preoperative diagnosis particularly challenging.

 Case Presentation: A 59-year-old woman was admitted with a history of recurrent upper abdominal pain lasting over one year. Computed tomography, gastroscopy, and endoscopic ultrasound revealed a submucosal mass in the gastric fundus, initially thought to be a gastrointestinal stromal tumor. The patient underwent exploratory laparotomy with wedge resection of the gastric wall. Gross examination revealed a cystic lesion containing dark red, viscous fluid. Histopathological examination revealed a gastric wall cyst and a leiomyoma. On immunohistochemistry, smooth muscle actin (SMA) and desmin were positive, and CD117, CD34, and S-100 were negative, confirming the diagnosis of gastric leiomyoma and excluding gastrointestinal stromal tumor (GIST).

 Outcome: The postoperative period was uneventful, and the patient recovered without complications. Three-year follow-up (endoscopy and MRI) revealed no recurrence or residual gastric lesion, and the patient was clinically well.

 Conclusion: Gastric wall cyst associated with gastric leiomyoma is an extremely rare entity that can be mistaken for a gastrointestinal stromal tumor on preoperative imaging. Definitive diagnosis is made by histopathological examination and immunohistochemistry. If malignancy cannot be ruled out, complete surgical removal is the most promising treatment, with excellent long-term results.