Differential Diagnosis for a 75-year-old Female with a Gastric Exophytic Lesion on CT Scan
Single Most Likely Diagnosis
- d. Adenocarcinoma: This is the most common type of gastric cancer, and its incidence increases with age. An exophytic lesion in the stomach of a 75-year-old female raises a high suspicion for adenocarcinoma due to its prevalence and the patient's age.
Other Likely Diagnoses
- b. Leiomyosarcoma: Although less common than adenocarcinoma, leiomyosarcoma is a type of soft tissue sarcoma that can occur in the stomach. Exophytic growth is consistent with this diagnosis, and it should be considered, especially if the lesion has characteristics suggestive of a sarcoma on imaging.
- a. Leiomyoma: This is a benign tumor of smooth muscle origin and can occur in the stomach. While typically smaller and less likely to cause significant symptoms, large leiomyomas can present as exophytic lesions. However, the age and presentation might slightly lower the likelihood compared to malignant options.
Do Not Miss Diagnoses
- c. Lymphoma: Gastric lymphoma, although less common than adenocarcinoma, is a critical diagnosis not to miss due to its different treatment approach and potential for significant morbidity if not promptly addressed. Lymphoma can present with a wide range of appearances on CT, including exophytic lesions.
Rare Diagnoses
- Other rare tumors: Including but not limited to gastrointestinal stromal tumors (GISTs), neuroendocrine tumors, and metastatic lesions to the stomach from other primary sites. These are less common and might be considered based on specific imaging characteristics, clinical presentation, and laboratory findings.
- Inflammatory or infectious lesions: Although very rare to present as an exophytic mass, certain inflammatory or infectious processes could potentially mimic a neoplastic lesion on imaging. These would be unusual and typically associated with specific clinical contexts or findings.