PMC9729990_01
Esophagogastroduodenoscopy (EGD) showed narrowing in the outlet of the stomach.
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Gastroduodenoscopy was performed, and the findings are shown in Figure 1.
Axial section abdominal CT shows gastric dilatation with residue.
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Abdominal computed tomography (CT) was initially negative, with no significant changes in the abdominal viscera (Figure 2).
The barium swallow study at the 45th min shows slow movement of barium from the stomach through the pylorus to the duodenum.
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The patient underwent a barium swallow study to evaluate the results of the previous dilation; the barium swallow showed an obstruction in the duodenum (Figure 3).
(a) Photographs of the patient showing cutaneous and subcutaneous neurofibromas. (b) Multiple Cafe-au-lait macules. Characteristic features include even pigmentation and smooth, well-defined borders.
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A detailed physical re-examination was performed and we noticed multiple cafe-au-lait spots distributed on his trunk and multiple cutaneous neurofibromas over the face and neck (Figure 4(a) and (b)).
Spindle-shaped tumor cells arranged in fascicles and bundles occupying the submucosa and muscular layer: (a) H&E, x40 magnification; (b) H&E, x200 magnification; (c) H&E, x200 magnification; and (d) H&E, x200 magnification.
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It was resected and sent for pathological study that showed spindle-shaped tumor cells arranged in fascicles and bundles occupying the submucosa and muscularis propria, which suggested a spindle cell neoplasm, most likely GISTs (Figure 5).