An unusual gastric tumour with gastric outlet obstruction

Question

A 62-year-old male without significant medical history presented with intermittent epigastric pain and abdominal fullness for 2 months. He denied having bloody stool or weight loss. He visited the outpatient department, where the CT scan of abdomen was performed (figure 1). He then underwent oesophagogastroduodenoscopy (EGD), which revealed a subepithelial tumour at gastric antrum with obstruction of the pylorus (figure 2 and video in the online ). Endoscopic ultrasound sonography (EUS) was performed (figure 3).

What is your diagnosis?Answer

Gastric inflammatory fibroid polyp (IFP) with gastroduodenal intussusception and gastric outlet obstruction.

The EGD showed a subepithelial tumour at the posterior wall of antrum with gastric outlet obstruction and gastroduodenal intussusception, which was then reduced by air inflation. The EUS disclosed a hypoechoic tumour arising from the submucosal layer. He then received laparoscopic gastric tumour excision (figure 4). The histology revealed a 2.2x1.0 cm submucosal tumour composed...

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