Introduction:

Gastric leiomyosarcomas are extremely rare tumors, comprising 0.1-3% of all malignant gastric lesions; their diagnosis and management are still a gray area in medicine.

Objective:

To describe a gastric leiomyosarcoma case report with pulmonary and mesenteric metastases.

Methods:

A 70-year-old male with dyspepsia worsening within 3 months.

Results:

Endoscopy reports a polypoid lesion whose immunohistochemical result concludes a gastric leiomyosarcoma.

Conclusions:

Gastric leiomyosarcoma continues to be a rare entity. More case reports are necessary to improve its diagnosis and management.