Gastric mass-like shadow on abdominal X-ray after vomiting

A 61-year-old man was consulted to our hospital complained of repeating vomit after diner with drinking. He felt epigastric discomfort and nausea. On physical examination, tenderness was recognized in the same lesion. On abdominal X-ray, 30-mm diameter of round-shaped mass shadow was observed in the stomach gas imaging (Figure 1A). One-month prior to consultation, he received chest X-ray examination because of another reason. But similar mass-like shadow did not be confirmed in the stomach gas imaging with his chest X-ray (Figure 1B). Blood laboratory examination showed as following: white blood cell count 8150/μL, hemoglobin of 13.7 g/dL, and carcinoembryonic antigen (CEA) 2.1 ng/mL. Gastrointestinal endoscopic view demonstrated submucosal tumor in the posterior wall of gastric fundus lesion (Figure 1C). Finally, 30 × 30 × 25 mm of gastric tumor was surgically resected, and diagnosis of gastrointestinal stromal tumor (GIST) was performed. Immunohistological examination of the tumor showed positive with CD34 and c-kit.

Although GIST is a rare disease [1],[2], plain chest or abdominal X-ray could become a trigger to diagnose gastric tumor when enough air was filled in the stomach. In this case, stomach gas imaging with filled air after repeating vomit was useful for diagnosis.

A case of GIST showing gastric mass-like shadow of abdominal X-ray was reported.