[25 cases of gastric smooth muscle tumors and review of the literature].

25 gastric smooth muscle tumors (12 symptomatic leiomyomas, 9 fortuitously discovered leiomyomas and 4 leiomyosarcomas) are presented. Follow-up has lasted from 9 months to 9 years. We have correlated the epidemiology, symptoms and anatomopathology with the evolution of these cases, in an attempt to single out specific features of benign and malignant forms. The most relevant macroscopic criteria of malignity are: a tumor measuring over 5 cm in diameter, widespread intratumoral necrosis. The histologic degree of malignity depends on several criteria, of which the most important are: the number of mitoses per high power microscopic field, cellular pleomorphism. Barium meal detects all symptomatic gastric smooth muscle tumors, and echography has the advantage of objectivizing intratumoral necrosis. For benign as well as malignant tumors the excision should be minimal, leaving a 2 cm safety margin. Simple enucleation is ruled out. If possible, metastases should be removed with the same safety margin. There is a good correlation between histologic type and prognosis. One case in 4 is associated with another malignancy.