Introduction
Benign gastric tumours are uncommon and are most often found incidentally during gastroscopy. Their practical importance lies in recognising the few lesions with malignant potential, mainly adenomas and some gastrointestinal stromal tumours, and in choosing between endoscopic and surgical removal. This topic covers classification, clinical picture, diagnosis, treatment, complications and follow-up of the common benign epithelial and mesenchymal tumours of the stomach.
Classification
Gastric tumours are divided by their tissue of origin into epithelial (mucosal) lesions and mesenchymal (submucosal or deeper) lesions.
Clinical picture
- Most patients are asymptomatic; the lesion is found during investigation for another reason.
- Vague epigastric discomfort, early satiety, nausea or bloating may occur, especially with larger lesions.
- Bleeding: chronic occult blood loss leading to iron deficiency anaemia, or melaena and haematemesis from an ulcerated lesion.
- Large tumours may cause gastric outlet obstruction; intussusception into the duodenum is rare and described mainly for large polyps and lipomas.
- Large GIST may present with bleeding, a palpable epigastric mass or, rarely, perforation.