Presentation
Chronic epigastric pain.
Patient Data
Age: 70 years
Gender: Female
From the case:
Gastrointestinal stromal tumor (GIST) - stomach
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Well-circumscribed submucosal soft tissue mass measuring 75 X 53 X 48 mm arising from the body of the stomach, eliciting a low signal on T1, high signal on T2 with restricted diffusion and moderate heterogeneous enhancement on post-contrast sequences.
Simple small hepatic cysts, as well as small hemangiomas, are noted (incidental findings).
Small gallstones.
Case Discussion
MRI features of a submucosal tumor of the stomach suggestive of a gastrointestinal stromal tumor (GIST).
The main differential diagnosis includes the other gastrointestinal tumors:
- leiomyomas: most common in the esophagus
- lymphomas: more extensive mural thickening with lymphadenopathy
- schwannomas: typically homogeneous attenuation and tend to lack cystic change
- carcinoid: more common in the small bowel, polypoid/plaque-like growth +/- mesenteric metastases
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