Differential Diagnosis for Epigastric Mass
- Single most likely diagnosis
- Gastric cancer: This is a common cause of epigastric masses, especially in older adults with a history of smoking, alcohol use, or Helicobacter pylori infection. The mass is often associated with weight loss, abdominal pain, and difficulty swallowing.
- Other Likely diagnoses
- Peptic ulcer disease: A large peptic ulcer can present as an epigastric mass, especially if it is complicated by a perforation or penetration into adjacent organs.
- Pancreatic pseudocyst: A pancreatic pseudocyst can cause an epigastric mass, often associated with a history of pancreatitis, abdominal pain, and elevated pancreatic enzymes.
- Gastrointestinal stromal tumor (GIST): A GIST is a rare tumor of the gastrointestinal tract that can present as an epigastric mass, often associated with abdominal pain, bleeding, or obstruction.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pancreatic cancer: Although less common than gastric cancer, pancreatic cancer is a highly lethal disease that can present with an epigastric mass, often associated with jaundice, weight loss, and abdominal pain.
- Lymphoma: Lymphoma can cause an epigastric mass, especially if it involves the stomach or pancreas, and is often associated with systemic symptoms such as fever, night sweats, and weight loss.
- Aortic aneurysm: An abdominal aortic aneurysm can cause an epigastric mass, often associated with back pain, abdominal pain, and a palpable pulse.
- Rare diagnoses
- Gastric lymphoma: A rare type of lymphoma that involves the stomach and can present with an epigastric mass, often associated with abdominal pain, weight loss, and gastrointestinal bleeding.
- Gastric carcinoid tumor: A rare neuroendocrine tumor of the stomach that can present with an epigastric mass, often associated with abdominal pain, diarrhea, and flushing.
- Mesenteric cyst: A rare benign cyst of the mesentery that can cause an epigastric mass, often associated with abdominal pain and intestinal obstruction.