PMC7481502_01
Magnetic resonance imaging showing a solid-cystic lesion (A), measuring 19.5 x 13.5 x 16 cm, with thick and irregular walls (D), multiple septa interspersed with solid areas (B), peripheral contrast-enhancement (A, B and D), located in the right hypochondrium, bulging the gallbladder superiorly (C).
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Magnetic resonance imaging (MRI) confirmed to be a cystic-solid mass of approximately 19.5 x 13.5 x 16 cm in right anterolateral situation, located between the liver, gallbladder, pancreas head and ascending colon, with thick and irregular walls and multiple septa interspersed with solid areas (Fig. 1-B and C). Furthermore, it showed peripheral contrast-enhancement (Fig. 1-A and D) and multiple cholelithiasis in the gallbladder (Fig. 1-C).
Surgical specimen. A large cystic-solid mass arising from the excluded stomach, and the gallbladder without morphological alterations.
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Intraoperative findings were a large cystic-solid and hypervascular tumor, fulfilling the entire mesogastrium within the peritoneal cavity, with epicenter and origin in the excluded stomach (post-RYGB) (Fig. 2).
Hematoxylin-eosin (HE) staining showing mesenchymal neoplasm, comprised of atypical epithelioid cells surrounded by a partially hyalinized stroma. Immunohistochemistry (IHC) positive for DOG1 CD34 and negative cKit.
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Immunohistochemistry (IHC) showed DOG1 (+), CD34 (+) and cKit (-) (Fig. 3).