Differential Diagnosis for Lobular Hyper-Enhancing Mass in the Distal Gastric Body
Single Most Likely Diagnosis
- Gastrointestinal Stromal Tumor (GIST): This is the most likely diagnosis due to the location and description of the mass. GISTs are the most common mesenchymal neoplasms of the gastrointestinal tract, often presenting as a hyper-enhancing mass on imaging, particularly in the stomach.
Other Likely Diagnoses
- Gastric Adenocarcinoma: Although less likely than GIST given the description, gastric adenocarcinoma can present as a mass in the stomach and must be considered, especially if there are risk factors or symptoms suggestive of malignancy.
- Leiomyoma: A benign smooth muscle tumor that can occur in the stomach, presenting similarly to GIST on imaging. However, leiomyomas are typically smaller and less likely to cause significant symptoms unless they ulcerate or outgrow their blood supply.
- Gastric Lymphoma: Can present as a mass in the stomach, though it might have different imaging characteristics, such as more diffuse involvement or associated lymphadenopathy.
Do Not Miss Diagnoses
- Gastric Carcinoid Tumor: Although less common, carcinoid tumors can present as a mass in the stomach. They are important to diagnose due to their potential for malignancy and systemic effects, such as carcinoid syndrome.
- Metastasis to the Stomach: Rare, but possible, especially from breast, lung, or melanoma primaries. Recognizing metastasis is crucial for staging and treatment planning.
Rare Diagnoses
- Gastric Schwannoma: A rare, benign tumor of the stomach that can mimic GIST on imaging. It originates from Schwann cells and is typically less aggressive.
- Inflammatory Fibroid Polyp: A rare, benign lesion that can occur in the stomach, presenting as a mass. It is composed of fibrous and inflammatory tissue.
- Gastric Glomus Tumor: An exceedingly rare tumor originating from glomus cells, which can present as a gastric mass. It is usually benign but can be malignant in rare cases.