Clinical presentation

A 65-year-old woman was referred to our hospital for evaluation of a gastric lesion initially diagnosed by medical check-up. She showed an unremarkable medical history, family history and physical examination, and no significant abnormalities on laboratory findings, including serum carcinoembryonic antigen and cancer antigen 19-9 levels. Oesophagogastroduodenoscopy revealed a slightly elevated lesion with a central, irregular depression in the greater curvature side of the middle third of the stomach (figure 1). Double-contrast upper gastrointestinal imaging showed a filling defect with central collection of barium measuring 2.0 cm with a clear margin and irregular boundary in the middle part of the stomach. Abdominal contrast-enhanced CT revealed no evidence of gastric mass, hepatic lesions or ascites, while chest X-ray and 18F-2-deoxy-2-fluoro-D-glucose positron emission …