Gastric cardiac leiomyoma complicated with massive gastrointestinal bleeding: A rare case report.

RATIONALE: We report a rare case of gastric cardiac leiomyoma with massive gastrointestinal bleeding as the first symptom that presented. This is the first case of this rare condition occurring in a patient younger than 20 years old. Positive results could not be obtained by routine biopsy, and the diagnosis was finally confirmed by endoscopic ultrasound-guided fine-needle aspiration biopsy.

PATIENT CONCERNS: A man aged less than 20 years old presented to the emergency department of the hospital due to upper gastrointestinal bleeding for 2 days.

DIAGNOSES: Emergency gastroscopy revealed that a bulging mass could be seen at the gastric cardia. Computed tomography revealed a large hypoechoic mass in the cardia of the fundus without enhancement. Finally, endoscopic ultrasound-guided fine-needle aspiration biopsy was performed. The pathological diagnosis was a leiomyoma.

INTERVENTIONS: The patient ultimately opted for total gastrectomy.

OUTCOMES: The patient's gastric cardiac leiomyoma was completely resolved, and no digestive tract symptoms recurred after 1 month of follow-up.

LESSONS: For young patients with upper gastrointestinal bleeding, we should also be aware of the possibility of other rare causes. Endoscopic ultrasound-guided fine-needle aspiration is very valuable for the diagnosis of submucosal tumors.