Answer of January 2004

Clinical History:

M/73yr. Ischaemic heart disease. Incidental finding of anaemia

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Diagnosis:

Malignant GIST ( GI Stromal Tumour ) of stomach

Discussion:

There is a large heterogeneous oval lesion in the left upper abdomen which has close relation with the gastric fundus. It extends to the left retroperitoneum. The spleen is displaced laterally. The lateral limb of the left adrenal gland and the tail of pancreas are in contact with the lesion. No ascites or lymph node enlargement is seen. The left kidney is not involved. Malignant GISTs of stomach typically has no ascites, bowel obstruction or lymph node metastases. The differential diagnosis is malignant adrenal tumour.