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Special Feature
June 1, 2004

Image of the Month—Quiz Case

Author Affiliations

From the Departments of Surgery (Drs Zeebregts and Gerritsen) and Radiology (Dr Slot), Medisch Spectrum Twente, and Laboratorium Pathologie Oost Nederland (Dr Brinkhuis), Enschede, the Netherlands. Dr Zeebregts is now with the Department of Surgery, University Hospital Groningen, Groningen, the Netherlands.



Arch Surg. 2004;139(6):687. doi:10.1001/archsurg.139.6.687

A 31-year-old, otherwise healthy woman was admitted with recurrent epigastric pain of 4 years' duration. Results of physical and laboratory examinations showed no abnormalities. A gastroduodenoscopy showed a homogeneous, round bulging structure, of which biopsy results showed normal gastric mucosa. A single-slice spiral computed tomography scan demonstrated a 7 × 5-cm well-circumscribed mass, located dorsal to and in narrow contact with the stomach (Figure 1), that could not be fully separated from the normal pancreatic tail. However, magnetic resonance images showed no relation to the pancreas. Through a midline laparotomy, the mass was found to be adherent to the stomach but not to the pancreas. The tumor was removed by local excision, and the gastric wall was closed. The findings in Figure 2were noted at histologic examination. The patient had an uneventful recovery.

What Is the Diagnosis?

A.Gastric leiomyoma B.Gastric duplication cyst C.Pancreatic pseudocyst D.Omental cyst