Gastric cysts are a rare disease and their diagnostic work-up often produces inconclusive results. We report on four gastric stromal tumors, in part huge, with cystic degeneration where the diagnosis and organ of origin remained unclear until operation. Considering these tumors as examples we discuss means and limits of differential diagnosis, taking into account further diseases with cystic formations in the gastric wall, such as other soft tissue tumors, pancreatic pseudocysts and gastric duplication cysts. In conclusion, every cystic tumor in the upper abdomen for which a diagnosis and origin cannot be established should be explored by surgery.
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