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Gastrointestinal stromal tumors (GISTs) commonly occur in the stomach and small intestine, are great mimickers of benign as well as malignant conditions, and can lead to diagnostic dilemma. A misdiagnosis of a malignant tumor directly affects the prognosis of a patient. We present the case of a 32-year-old male with symptoms of acid peptic disease who underwent a diagnostic upper gastrointestinal (UGI) endoscopy and was diagnosed to have a gastric ulcer without a biopsy. As his symptoms persisted along with melena, he visited our center and was found to be severely anemic and tachycardic. A repeat UGI endoscopy revealed a gastric tumor that was resected and reported to be GIST. The deceptive looks of a benign gastric ulcer and deferring a biopsy at the first UGI endoscopy delayed the diagnosis in this patient which is definitely an error. The case illustrates that one should consider a differential diagnosis of GIST in ulcerative and bleeding gastric lesions.
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