A 67-year-old hypertensive patient with no history of gastroduodenal ulcus or intake of gastrolesive drugs, who consulted the emergency department for melena and progressive fatigue of about two weeks' duration. Laboratory tests showed a Hb of 9.8, with pallor on physical examination, normotensive and acceptable general condition with negative rectal examination.
An upper endoscopy showed a large submucosal lesion in the gastric fundus, excavated in the centre by a fibrinous ulceration with no signs of current or recent active bleeding. It was interpreted as an ulcerated gastric submucosal lesion, most probably leiomyomatous, responsible for the gastrointestinal bleeding.

Radial echoendoscopy confirmed the submucosal nature of the lesion, which was dependent on the fourth layer of the gastric wall (muscularis propria), hypoechogenic, homogenous, with delimited borders and a maximum diameter of 4.6 x 3.4 cm. Its border on the face of the gastric lumen showed an excavation secondary to an ulcer of about 2 cm in size. No perilesional or celiac trunk lymphadenopathy was observed. An echoendoscopic diagnosis was made of a gastric submucosal stromal tumour (GIST tumour) of probable muscular lineage.
With this diagnosis and due to the echoendoscopic criteria of size (greater than 4 cm) and haemorrhagic complication, elective surgical treatment was performed by resection and enucleation of the lesion.
Histological study of the resected specimen yielded a gastric schwannoma.