Exogastrically Developed Pedunculated Epithelioid Leiomyoma of the Stomach

Epithelioid leiomyomas of the gastrointestinal tract are difficult to diagnose before surgery and their malignancy is not readily evaluated. The tumor is of smooth muscle origin, arising from the muscularis propria, and frequently develops in the gastrium, occasionally extending into the gastrocolic ligament or greater omentum. Malignancy is evaluated from the numbers of mitotic cells per 50 high power fields. However, even a tumor with few mitoses may metastatize. Thus, we propose that the malignancy of the tumor should be decided in terms of location, size, pattern of growth, invasion of the mucosa, cellularity, mitotic rate, and anaplasia. We reported a case of epithelioid leiomyoma that was pedunculated, with exogastric expansion. The literature is reviewed.