Residency Program - Case of the Month
January 2013 - Presented by Brian Gorospe, M.D.
A 63-year-old female with a past medical history of gastrointestinal bleeding from a gastric ulcer and H. pylori infection presented with new complaints of melena, progressive weakness, fatigue and shortness of breath. Labs were consistent with iron deficiency anemia and a hemoglobin of 3.2 g/dL. An upper endoscopy revealed a large, ulcerated gastric mass between the incisura and antrum, concerning for malignancy (Figure 1). Abdominal CT scan demonstrated a 9.0 x 6.0 x 5.5 cm multilobulated enhancing mass involving the body and antrum, extending beyond the borders of the stomach (Figure 2).
|Figure 1||Figure 2|
An endoscopic biopsy of the gastric mass was performed and included fragments of benign gastric mucosa with ulceration, as well as a small fragment of a poorly differentiated epithelioid neoplasm (Figure 3).
|AE1/AE3:||positive (figure 4)|
|CD117:||positive (figure 5)|
|Figure 4||Figure 5|