PMC6151684_01
(a) CT imaging of the abdomen and pelvis with IV and oral contrast. Initial presentation with gastric mass and liver metastasis. (b) Repeated imaging on subsequent admission 6 weeks later with an increase in the size of gastric mass and liver invasion and worsening metastasis.
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A computed tomography (CT) scan of the abdomen/pelvis with contrast (Figure 1(a)) showed a partially exophytic lobular mass along the superior wall of the gastric fundus measuring 4.5 x 4.3 x 2.0 cm, seven lesions within the liver with the largest measuring 2.2 x 2.0 x 2.5 cm, and a metastatic lymph node anterior to the GE junction. She presented again with nausea and vomiting in a couple of months and a repeat CT scan of the abdomen/pelvis (Figure 1(b)) showed an increase in the gastric mass to 8.7 cm with ulceration and invasion of the left lobe of the liver.
(a) EGD showing lobulated mass measuring at least 3-4 cm in length (A, B) and 2-3 cm in diameter (C, D). (b) H&E staining at lower (4x) and higher magnifications (20x) showing characteristics of gastric carcinoma.
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EGD showed a large polypoid fundic mass (Figure 2(a)). H&E staining demonstrated characteristics of gastric carcinoma (Figure 2(b)), with final pathological findings of a sarcomatoid carcinoma which was positive for cytokeratin, SMA, desmin, and GATA3.