case_images: PMC9729990_01
case_images: Esophagogastroduodenoscopy (EGD) showed narrowing in the outlet of the stomach.
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case_images: Gastroduodenoscopy was performed, and the findings are shown in Figure 1.
case_images: Axial section abdominal CT shows gastric dilatation with residue.
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case_images: Abdominal computed tomography (CT) was initially negative, with no significant changes in the abdominal viscera (Figure 2).
case_images: 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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case_images: 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).
case_images: (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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case_images: 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)).
case_images: 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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case_images: 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).