case_images: PMC6393670_01
case_images: Gallbladder adenocarcinoma: (A) Mucosa with intestinal metaplasia(arrow) and architecture destruction (left side) caused by infiltrative epithelial neoplasia (H&E 10x); (B) Infiltrative neoplasia with large nucleus, evident nucleolus and creating tubular structures (arrow) (H&E 20x).
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case_images: It was reported as an adenocarcinoma of 1,1 cm with free margins, subserosal invasion, with no lymphatic or perineural involvement, staging pT2NxMx (Fig. 1).
case_images: Abdomen CT for staging of gallbladder adenocarcinoma: Wall thickening in the proximal gastric segment with exophytic component close to the lesser curvature, measuring 5 x 4 cm (arrow).
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case_images: In October 2016 a staging abdominal computerized tomography(CT) was performed and showed irregular wall thickening in the proximal gastric segment with exophytic component close to the lesser curvature, measuring 5 x 4,5 cm (Fig. 2).
case_images: Upper gastrointestinal endoscopy: CT finding of an exophytic mass in the gastric small curvature was corroborated by further endoscopical evaluation.
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case_images: One week later an upper gastrointestinal endoscopy found a submucous lesion 3 cm below the cardia, with central ulceration and indurated edges (Fig. 3).
case_images: Histopathological analysis of gastric lesion: (A) Mucous ulceration by expansive growth of the gastric wall neoplasm (H&E 20x); (B) Neoplastic cells with positive immunoexpression of CD117/c-kit (H&E 20x).
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case_images: Histopathologic analysis of the ulcerated lesion showed mucous ulceration by expansive growth of the gastric wall neoplasm with positivity to CD117, CD34 and DOG-1 and negativity to S100, Desmin, AE1AE3 and smooth-muscle actin (Fig. 4).