A mass seen under gastroscopy "disappeared" during laparotomy.

Area of Science:

• Gastroenterology and Hepatology
• Diagnostic Imaging

Background:

• Submucosal tumors (SMTs) of the stomach can present diagnostic challenges.
• Hepatic cavernous hemangiomas are benign vascular liver tumors.

Observation:

• A 36-year-old man presented with a gastric submucosal tumor on gastroscopy.
• Endoscopic ultrasound (EUS) and CT scans suggested a gastric duplication cyst.
• Laparotomy revealed a spherical mass originating from the liver's triangular ligament.

Findings:

• The gastric lesion was a misdiagnosis; the actual pathology was a hepatic cavernous hemangioma.
• Initial imaging modalities (EUS, CT) failed to correctly identify the liver origin.

Implications:

• This case underscores the potential for misdiagnosis when differentiating gastric SMTs from intra-abdominal masses.
• Accurate preoperative diagnosis is crucial for appropriate patient management and surgical planning.
• Radiologists and gastroenterologists should consider hepatic lesions in the differential diagnosis of gastric submucosal tumors.