Leiomyoblastoma is a rare, smooth muscle tumor of the stomach that occurs chiefly in the antrum. We present the case of a 51 year old man suffering from asthenia and mild upper abdominal pain. Investigations showed a big exculcerated tumor of the lesser gastric curvature. He underwent a subtotal gastrectomy for a non-metastasizing leiomyoblastoma, grade 1. But already 5 months later, he developed an invasive non-resectable local recurrence of high grade malignancy and died 3 month after a second look. Those tumors affect middle-aged patients who present usually upper gastrointestinal bleeding or peptic ulcer-like symptoms. Although the large majority of leiomyoblastoma are benign, malignancy occurs in up to 10% of cases. A large surgical resection of the tumor (including the total thickness of the gastric wall) or a partial gastrectomy is recommended.
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