An Unexpected Gastric Subepithelial Mass

Abstract

A 63-year-old man came to our observation complaining of symptoms referable to gastroesophageal reflux disease. No epigastric pain, postprandial fullness, or vomiting were present during clinical examination. His history did not show noteworthy pathologies. The patient did not follow any pharmacological therapy, and there was no family history for neoplasia of the digestive system. An esophagogastroduodenoscopy was performed, which showed, in the insufflation phase, a ‘bombè’ lesion occurring in the fundus driven to subepithelial lesions (SELs), settled along the little curve and miming an extrinsic compression. Laboratory tests were all normal, including liver function tests, while the oncological markers (carcinoembryonic antigen and serum carbohydrate antigen 19-9) were both negative. An abdominal computed tomography (CT) with contrast agent was performed, highlighting two fluid collections, of which the larger mass (48 × 43 mm) lay in the right lobe and the smaller mass (33 × 27 mm), responsible for compression on the gastric wall, in the left lobe.