Gastrointestinal stromal tumor (GIST) - gastric

Case contributed by Ammar Haouimi
Diagnosis probable

Presentation

Right upper quadrant pain with no obstructive jaundice. The ultrasound showed a solid mass in the left hypochondrium.

Patient Data

Age: 75 years
Gender: Female

There is a well-circumscribed soft tissue mass (8x5 cm) of interspleno-gastric location inseparable from the posterior gastric wall, of intermediate signal intensity on T1WI, and T2WI with central areas of high signal (necrosis). Subtle peripheral enhancement is noted, following IV contrast. On DWI it appears of high signal with low ADC.

The gallbladder is normal in size, containing gallstones with the enhanced wall. The common bile duct is dilated (9 mm), containing few small stones in its distal portion.

A focal right diaphragmatic defect is noted with intrathoracic herniation of the hepatic dome and right colonic flexure, well-visualized on the coronal sequence.

Case Discussion

MRI features are suggestive of a GIST of the stomach (incidentaloma), discovered during an ultrasound in a patient with cholecystolithiasis/choledocholithiasis, and a right diaphragmatic hernia.

Additional contributor: Djamel Hamadi, MD EPH Ouargla.

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