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An unusual intra-abdominal tumour
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  1. M H Shiwania,
  2. D J Breenb,
  3. T Gilesc,
  4. K R Wedgwooda
  1. aCastle Hill Hospital, Hull, UK: Department of Surgery, bDepartment of Radiology, cDepartment of Pathology
  1. Mr K R Wedgwood, Department of Surgery, Castle Hill Hospital, Cottingham, Hull HU16 5JQ, UKkevwed{at}aol.com

http://dx.doi.org/10.1136/pmj.77.911.605

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    Answers on p 613 .

    A 72 year old men presented with a five week history of intermittent upper abdominal pain radiating to the flanks, lasting for several hours, aggravated by walking and movement and with one episode of vomiting. There were no other associated gastrointestinal symptoms. General examination was unremarkable. Abdominal examination revealed a large, smooth, and non-tender mass in the upper abdomen, which moved with respiration. Baseline haematology and biochemistry were normal. Ultrasound scan of the abdomen suggested a soft tissue mass, arising from either stomach or pancreas. Upper gastrointestinal endoscopy did not show any abnormality in the stomach or duodenum. A contrast enhanced computed tomogram is shown in fig 1. Distal partial gastrectomy was performed with en bloc resection of omentum and gastrojejunostomy fashioned. The gross pathological specimen is shown in fig 2 and microscopy in figs 3 and 4. The patient made an uneventful postoperative recovery. 

    Figure 2
    Figure 2

    Gross pathology specimen.

    Questions

    (1) Comment on the computed tomogram.

    (2)
    Describe the macroscopic appearance of the specimen.
    (3)
    Describe the histological features.