Adenocarcinoma arising from a gastric submucosal intraductal papillary mucinous neoplasm.

摘要

A 79-year-old man was referred for an EUS evaluation of a suspected gastric stromal tumor found incidentally by CT scan. At endoscopy, a subepithelial mass was found in the gastric fundus (A). The mass had a central opening that appeared to exude mucin (A, arrow). Linear EUS (GF-UC140P; Olympus Optical Co, Tokyo, Japan) showed a 29 X 16 mm complex cystic mass that arose from the submucosa (B, arrow), and that consisted of multiple anechoic tubular duct-like structures (B, arrowheads), with a few nodules/ projections (B, double arrows). FNA of the cyst obtained 3 mL of fluid, and forceps biopsy specimens were obtained from within the lesion via the cyst orifice (C). Lipase and carcinoembryonic determinations could not be performed on the fluid because it was too viscous to be run, even after dilution.