PMC5992336_01
Axial computed tomography showing a large mass projecting intraluminally at the posterior fundal aspect of the stomach.
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F1
Abdominal computed tomography (CT) revealed a fungating, intraluminal mass (5.8 x 6.6 x 8.2 cm) arising from the posterior fundal aspect of the stomach (Figure 1).
Large, heterogeneous, hypoechoic mass with cystic cavities arising from the submucosal layer of the stomach seen on endoscopic ultrasound (EUS).
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F2
On EUS, the mass was mostly hypoechoic with anechoic cystic cavities arising from the submucosal layer with no invasion of the deeper layers of the stomach (Figure 2).
EUS-guided fine-needle aspiration sample showing dehisced atypical epithelium with malignant cytological features consistent with adenocarcinoma (100x).
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F3
Fine-needle aspiration from EUS showed high-grade dysplastic epithelium with cribriform appearance but no overt stromal invasion, in keeping with adenocarcinoma (Figure 3).
Gross appearance of the transected duplication cyst, an endophytic submucosal mass comprised of thickened undulating mucosa and underlying layer of attenuated muscle.
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F4
Gross appearance of the transected duplication cyst after laparotomy was an endophytic submucosal mass composed of thickened undulating mucosa and an underlying layer of attenuated muscle (Figure 4).
(A) Surgical pathology of thickened mucosa from gastric duplication cyst showing high-grade dysplasia and adenocarcinoma arising in a background of hyperplastic changes with intestinal metaplasia. (B) Further sectioning of the lesion revealing multiple microscopic foci of invasive adenocarcinoma infiltrating submucosa (pathological stage pT1bN0) (100x).
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F5
Surgical pathology confirmed moderately differentiated invasive adenocarcinoma, clear cell variant with a maximum dimension of 2 cm, arising from an 8-cm foregut duplication cyst (Figure 5).