Presentation
Abdominal discomfort.
Patient Data
Mild mesenteric panniculitis. Incidental bilobed enhancing partially exophytic mass in the proximal jejunum (GIST). No other significant findings.
MRI without and with contrast and MRA (to exclude an aneurysm), showing heterogeneous non-aneurysmal pattern of enhancement of the mass during the arterial phase, and without other significant information provided by this study.
Gross specimen showing the exophytic relationship of the mass with the bowel wall.
Case Discussion
This case highlights the workup of an incidental enhancing jejunal mass on CT. The MRA helps to exclude a vascular etiology (specifically aneurysm) which would require a different surgical approach. The most likely diagnosis for a small bowel mass in this location is GIST, but other less likely possibilities include carcinoid tumor, adenocarcinoma, and lymphoma.
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