A 68-year-old woman who had previously undergone small intestinal rese
ction because of leiomyosarcoma was referred to our clinic with epigas
tric pain. A double-contrast barium study and the subsequent abdominop
elvic CT and abdominal MRI examinations demonstrated multiple extralum
inal growing tumors arising from the walls of stomach, small bowell, a
nd colon. A CT-guided aspiration biopsy revealed malignant mesenchymal
tumor. The presence of disseminated intra-abdominal masses without co
ncomitant ascites and invasion of tissue planes on CT in a patient ope
rated on prior because of a leiomyosarcoma led to the diagnosis of gas
trointestinal leiomyosarcomatosis. In this report we discuss the radio
logical approach to this rare entity.