Presentation
Abdominal pain and left upper quadrant mass feeling on physical exam.
Patient Data
A sizable exophytic gastric mass with large areas of internal necrosis is seen in the left upper quadrant, that displaces adjacent anatomical structures without invasion or encasement.
Several enlarged lymph nodes are seen in the vicinity of the mentioned mass and para-aortic regions with SAD less than 16 mm.
A few small low-enhancing masses are seen in the liver less than 10 mm.
A small volume of pericardial effusion is present.
Several non-enhanced simple cortical cysts are seen in both kidneys. Additionally, a 30 mm stone is noted in the right renal pelvis that causes moderate hydronephrosis. A 12 mm stone is also noted in the lower calyx of the right kidney.
Case Discussion
The patient underwent gastric mass excision and histopathology evaluation confirmed gastrointestinal stromal tumor (GIST) with malignant transformation.
The stomach is the most common site for GIST and the GIST is the most common sarcoma of the stomach. Differentiating between a benign from a malignant GIST radiologically is difficult. The diagnosis of malignant GIST requires histopathologic analysis, but certain characteristics suggest malignancy including exogastric growth, diameter >5 cm, central necrosis and extension to other organs.
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