case_images: PMC6151684_01
case_images: (a) CT imaging of the abdomen and pelvis with IV and oral contrast. Initial presentation with gastric mass and liver metastasis. (b) Repeated imaging on subsequent admission 6 weeks later with an increase in the size of gastric mass and liver invasion and worsening metastasis.
case_images: CRIONM2018-6469591.001.jpg
case_images: PMC6151684_01_CRIONM2018-6469591.001.jpg
case_images: fig1
case_images: A computed tomography (CT) scan of the abdomen/pelvis with contrast (Figure 1(a)) showed a partially exophytic lobular mass along the superior wall of the gastric fundus measuring 4.5 x 4.3 x 2.0 cm, seven lesions within the liver with the largest measuring 2.2 x 2.0 x 2.5 cm, and a metastatic lymph node anterior to the GE junction. She presented again with nausea and vomiting in a couple of months and a repeat CT scan of the abdomen/pelvis (Figure 1(b)) showed an increase in the gastric mass to 8.7 cm with ulceration and invasion of the left lobe of the liver.
case_images: (a) EGD showing lobulated mass measuring at least 3-4 cm in length (A, B) and 2-3 cm in diameter (C, D). (b) H&E staining at lower (4x) and higher magnifications (20x) showing characteristics of gastric carcinoma.
case_images: CRIONM2018-6469591.002.jpg
case_images: PMC6151684_01_CRIONM2018-6469591.002.jpg
case_images: fig2
case_images: EGD showed a large polypoid fundic mass (Figure 2(a)). H&E staining demonstrated characteristics of gastric carcinoma (Figure 2(b)), with final pathological findings of a sarcomatoid carcinoma which was positive for cytokeratin, SMA, desmin, and GATA3.