ABSTRACT
Leiomyosarcoma accounts for 1-3% of all the gastric malignancies. The most common clinical presentation of gastric leiomyosarcoma is gastrointestinal hemorrhage due to tumor ulceration. Surgical resection is the treatment of choice for gastrointestinal sarcomas and the appropriate surgical management requires deliberate efforts for complete excision of the tumor with an adequate margin of normal tissue. A 70-year-old woman was admitted to our hospital due to a melena persisting for 7 days. A gastrofiberscopy was performed and a large normal mucosa covered lobulated mass with deep multiple round ulcers were found in the fundus. A slightly protruding vessel was visible on the base of the posterior wall of the fundus. An abdominal CT revealed a heterogenous mass with irregular multifocal necrotic portions in the fundus. During on operation, a tumorous mass was found in the fundus. The liver was free of metastasis and lymphadenopathy was not discovered. A total gastrectomy, omentectomy, and an end to end esophagojejunostomy were performed. The pathologic diagnosis determined a high grade leiomyosarcoma.