Transverse colon cancer and gastric GIST

Case contributed by Dr Wayland Wang

Presentation

Iron deficiency anaemia for investigation. Right lower quadrant pain. No history of PR bleeding. 10 kg loss of weight over 2 months ?malignancy ?cause for anaemia.

Patient Data

Age: 75 years
Gender: Female

There is a large necrotic mass circumferentially involving the transverse colon, measuring approximately 12.4 x 7.8 x 7.8 cm (axial x SI). Oral contrast passes through the mass with no evidence of proximal large bowel obstruction.

No discrete enlarged lymph nodes are identified, but there are several lobulated masses adjacent to and continuous with the mass, which may represent engulfed lymphadenopathy.

There are adjacent loops of small bowel which demonstrate mural thickening, at least one of which is contiguous with and inseparable from the inferior margin of the mass. There is no upstream dilatation to suggest obstruction.

There is a well-circumscribed ovoid 21 mm mass indenting the greater curvature of the stomach. This appears to arise extrinsic to the stomach.​

Conclusion:

Large neoplastic lesion involving the transverse colon, without evidence of obstruction.
This appearance is suspicious for lymphoma, with a differential of carcinoma.

Extrinsic mass indenting the greater curvature of the stomach may represent a gastrointestinal stromal tumor.

Case Discussion

Transverse colon adenocarcinoma and gastric GIST confirmed at surgery.

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Case information

rID: 59223
Published: 27th Mar 2018
Last edited: 28th Mar 2018
Inclusion in quiz mode: Included

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