Benign gastric tumors account for approximately 2% of all gastric tumors. Based on tissue origin, they can be classified into epithelial-origin benign tumors and mesenchymal-origin benign tumors. Among the former, gastric adenomas and adenomatous polyps are the most common, constituting approximately 40% of benign gastric tumors. These are frequently found in the antrum of the stomach, appearing as polypoid lesions, either solitary or multiple, with a certain potential for malignancy, especially for broad-based adenomas with a diameter larger than 2 cm. Mesenchymal-origin benign gastric tumors primarily include leiomyomas, fibromas, lipomas, hemangiomas, and neurofibromas, among which leiomyomas are the most common. Leiomyomas are frequently located in the gastric body or antrum.
Benign gastric tumors generally progress slowly. Common clinical manifestations include:
- Epigastric discomfort, a sense of fullness, or abdominal pain.
- Upper gastrointestinal bleeding.
- Abdominal mass, with larger tumors being palpable in the epigastrium.
- Tumors located at the cardia or pylorus may cause partial obstruction.
Examinations such as X-ray barium studies, gastroscopy, ultrasound, and CT scans are valuable for diagnosis. Gastroscopy has significantly improved the detection rate of benign gastric tumors. For tumors originating from the mucosa, biopsy helps confirm the diagnosis. For mesenchymal tumors located beneath the mucosa, endoscopic ultrasound offers greater diagnostic value.
Treatment
Surgical resection is the mainstay of treatment for benign gastric tumors. Since it is clinically difficult to exclude malignant tumors, and because some benign gastric tumors carry a risk of malignant transformation or may lead to serious complications, active surgical treatment is recommended upon confirmation of the diagnosis. The surgical approach is determined based on the size and location of the tumor, as well as the potential for malignancy. For small adenomas or adenomatous polyps, endoscopic resection is an option. Larger tumors may require partial gastrectomy or subtotal gastrectomy. Intraoperative frozen-section pathological examination is necessary to promptly detect any malignant transformation.