Presentation
Abdominal discomfort.
Patient Data
Relatively subtle gastric fundal thickening and enhancement. The degree of enhancement extending from the superior and inferior aspects of the fundus can be appreciated on sagittal images. No liver lesions or adenopathy. No peritoneal disease. Mild left hydroureteronephrosis. Mildly trabeculated urinary bladder.
Case Discussion
Subtle case of infiltrative gastric adenocarcinoma or lienitis plastica (confirmed with endoscopy), which can be appreciated by the nature of the transmural enhancement of the gastric fundus, indicating the infiltrative tumour rather than if it were just the mucosa (favouring inflammation instead). Important things to look for in addition would be surrounding adenopathy, particularly in the gastrocolic ligament and peritoneal disease. The patient also has mild left hydroureteronephrosis, probably related to outflow compromise as the bladder appears mildly trabeculated.
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