Acute gastrointestinal hemorrhage as the sole initial manifestation of gastric leiomyosarcoma: a case report highlighting the discrepancy between preoperative assessment and final pathology - Takeaways - MDSpire

Acute gastrointestinal hemorrhage as the sole initial manifestation of gastric leiomyosarcoma: a case report highlighting the discrepancy between preoperative assessment and final pathology

  • By

  • Kaini Li

  • Yuan Zhang

  • Liangchen Li

  • Liwei Liu

  • Shangyumeng Zhao

  • Chuanjie Yang

  • June 24, 2026

  • 0 min

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  • 1

    Gastric leiomyosarcoma (LMS) is a rare mesenchymal malignancy, accounting for 1% of malignant gastric tumors.

  • 2

    A 78-year-old female presented with acute upper gastrointestinal hemorrhage as the sole initial symptom of gastric LMS.

  • 3

    Endoscopic biopsy and imaging underestimated the tumor's infiltrative extent and proliferative activity, highlighting diagnostic challenges.

  • 4

    Final pathology revealed LMS with a Ki-67 index of 50% and a mitotic count of 13/10 high-power fields.

  • 5

    Accurate diagnosis requires immunohistochemical exclusion of gastrointestinal stromal tumor (GIST) and close postoperative surveillance.

Original Source(s)

Acute gastrointestinal hemorrhage as the sole initial manifestation of gastric leiomyosarcoma: a case report highlighting the discrepancy between preoperative assessment and final pathology

  • by Kaini Li, Yuan Zhang, Liangchen Li, Liwei Liu, Shangyumeng Zhao, Chuanjie Yang

  • June 24, 2026

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