Mucormycosis Masquerading as Gastric Tumor

CASE REPORT A 50-year-old man was admitted with severe urinary tract infection secondary to ureteric obstruction with sepsis with multiple organ dysfunction syndrome in the intensive care unit after laser lithotripsy. He developed hematemesis of approximately 20 mL on day 7 of intensive care unit admission. The upper gastrointestinal tract endoscopy revealed a proliferative lesion in the gastric fundus approximately 3 × 3 cm in size with greenish exudate without any other erosions or ulcerations (Figures 1 and 2). Biopsies were taken from the lesion, and on histopathology, they revealed aseptate hyphae invading the gastric mucosa (mucormycosis) (Figure 3). The patient did not have history of diabetes mellitus, recent coronavirus disease 2019 infection, or other comorbidities. He had tested negative for HIV, had normal sugars, and had not received steroids recently. Plain abdominal computed tomography scan was performed for ureteric stone, which had not revealed any mass lesions in the stomach or otherwise. The patient developed shock on the day of endoscopy and was not on any empirical antifungal therapy. The patient unfortunately succumbed to the disease before the biopsy report could be obtained.Figure 1.: Proliferative mass-like lesion in the gastric fundus with greenish exudate.Figure 2.: Same lesion after vigorous flushing revealed erythematous friable mucosa that bled on touching.Figure 3.: Histopathology image in hematoxylin and eosin stain showing invasion with aseptate hyphae of mucormycosis (magnification 400×).Mucormycosis can present as a tumefactive lesion in the stomach in an immunocompetent patient, and suspicion should warrant early antifungal therapy and if needed surgery. DISCLOSURES Author contributions: V. Chaudhari: conceptualization, data collection and analysis, patient management, and writing and approving the final manuscript; A. Amrapurkar: data analysis, patient management, and approving the final manuscript; P. Rane: data analysis, patient management, and approving the final manuscript. V. Chaudhari is the article guarantor. Financial disclosure: None to report. Previous presentation: This case was presented at ENDOCON 2024; April 19–21, 2024; New Delhi, India. Informed consent was obtained for this case report.