2017-08-10 13:59:43 UTC

Submucosal Tumor of the Stomach With Drastic, Short-Term Changes in Morphology

Aug. 10, 2017

What caused the lesion in a man diagnosed with a submucosal tumor in the upper gastric corpus, to change to a reddish, semipedunculated tumor with blood oozing on the surface?

Gastroenterology Clinical Image Challenge: A 47-year-old man was referred to our institution for a detailed examination of a gastric tumor. One year previously, the patient was diagnosed as having a submucosal tumor in the upper gastric corpus by screening esophagogastroduodenoscopy (Figure A). On admission, laboratory tests were within normal limits and Helicobacter pylori was negative as determined by the stool antigen test and the serological test. Esophagogastroduodenoscopy revealed that the lesion had increased in size with ulceration (Figure B). Repeated biopsies from the lesion failed to achieve a definitive histopathological diagnosis. One month later, the lesion had changed to a reddish, semipedunculated tumor with blood oozing on the surface (Figure C). Endoscopic ultrasound examination showed that the tumor was located mostly in the submucosal layer (Figure D). Computed tomography depicted a well-circumscribed tumor in the stomach, which was enhanced with contrast medium, without any metastatic lesions.

What is the diagnosis?

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