A 46-year-old woman with dyspepsia of several years' duration that did not improve with medical-dietary treatment. Endoscopy revealed a submucosal lesion 1 cm in diameter, located on the posterior aspect of the gastric antrum with no signs of ulceration. The biopsy was suggestive of moderate congestion and focal oedema of the lamina propria. An antral gastrointestinal transit (GIT) and computed tomography (CT) scan showed a repletion defect with loss of mucosal folds compatible with the previously described tumour. During the follow-up, several endoscopic ultrasound scans (EUS) were performed, showing a hypoechoic, homogeneous lesion with regular borders, which appeared to depend on the muscular layer, measuring 2 x 1.6 cm with a soft consistency, compatible with a stromal tumour of the leiomyoma type, with no ultrasound signs suggesting malignancy. No significant adenopathy. FNA: epithelial cellularity without malignancy.

The increase in size of the lesion, the persistence of symptoms, the absence of a definitive diagnosis and the impossibility of ruling out malignancy led us to consider surgical removal.

Excision was performed laparoscopically, identifying the lesion by means of intraoperative endoscopy and Chinese ink staining prior to surgery. An anterior gastrostomy is performed and the resection is carried out with a 45 mm linear endograft (Ethicon Endo-surgery). Subsequently, the gastrostomy is closed with a continuous silk suture.

Macroscopically, the lesion has a solid consistency and the external surface is yellowish-whitish in colour. Microscopic examination identified heterotopic pancreatic tissue with a predominance of irregularly dilated ducts.

The postoperative period was uneventful and oral intake was resumed on the 4th day and the patient was discharged on the 7th day. The patient is currently asymptomatic.