Jedediah A. Kaufman, MD; Dave Lal, MD; Melissa P. Upton, MD; Carlos A. Pellegrini, MD; Brant K. Oelschlager, MDSeries Editors: Brant Oelschlager, MD; Carlos A. Pellegrini, MD

Disclosures

April 04, 2005

Case Presentation

A 70-year-old woman presented with a gastric-wall mass found on routine follow-up endoscopy performed after treatment for Helicobacter pylori and gastritis. The mass was discovered 3 years prior to presentation. No surgical treatment or biopsy was performed. The patient denied symptoms, except for heartburn. She was treated with an H pylori eradication regimen with resolution of her gastritis. Results of endoscopy (not shown) suggested a 2- to 3-cm subepithelial, lesser-curve, gastric-wall mass or extrinsic compression from an adjacent organ.

The patient denies nausea, vomiting, fever, chills, night sweats, weight loss, or change in bowel habits.

Her medical history was noncontributory, and her surgical history consisted of 2 cesarean sections and an appendectomy. Physical exam revealed a thin woman in excellent condition. No lymphadenopathy or abdominal mass can be palpated.

Which initial diagnostic study or studies would you use to evaluate the gastric mass?

  1. Abdominal ultrasound only

  2. Abdominal computed tomography (CT) and esophagogastroscopy with endoscopic ultrasound (EUS) and biopsy

  3. Abdominal CT scan with biopsy

  4. Repeat esophagogastroscopy only

  5. Magnetic resonance imaging (MRI) only

View the correct answer.

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