As seen in this patient, most benign gastric leiomyomas occur in adult patients and are asymptomatic until the lesions achieve significant size. Although surgery with curative intent is often performed in younger patients with leiomyomas, this patients advanced age and medical comorbidities make observation the most attractive option. Chemotherapy and radiation therapy are not performed in these patients. There is no need to perform a gastrojejunostomy because the tumor is not causing gastric outlet obstruction.