Abstract
BACKGROUND: Endoscopic resection of giant gastric leiomyomas, particularly in the fundus and cardia regions, is infrequently documented and presents a significant challenge for endoscopic surgery. CASE SUMMARY: Herein, a case of a 59-year-old woman with a giant gastric leiomyoma was reported. The patient presented to the department of hepatological surgery with a complaint of right upper abdominal pain for one month and worsening for one week. The patient was diagnosed as gastric submucosal tumor (SMT), gallstone, and cholecystitis combined with computed tomography and gastroendoscopy prior to operation. Upon admission, following a multi-disciplinary treatment discussion, it was determined that the patient would undergo a laparoscopic cholecystectomy and endoscopic resection of gastric SMT. It took 3 hours to completely resect the lesion by Endoscopic submucosal excavation and endoscopic full-thickness resection, and about 3 hours to suture the wound and take out the lesion. The lesion, ginger-shaped and measuring 8 cm × 5 cm, led to transient peritonitis post-surgery. With no cardiac complications, the patient was discharged one week after surgery. CONCLUSION: Endoscopic resection of a giant leiomyoma in the cardiac fundus is feasible and suitable for skilled endoscopists.