A 45-year-old woman without comorbidities presented with hematemesis 45 days prior. On examination, she was pale, and her systemic examination was unremarkable. Laboratory examination revealed iron-deficiency anemia. Upper gastrointestinal endoscopy revealed a large pedunculated polyp in the gastric fundus, measuring 5 cm, with a 1 cm vascular stalk (Figure 1A). Computed Tomography showed only a gastric polyp (Figure 1B). Endoscopic ultrasound (EUS) revealed a freely floating, isoechoic polyp with calcifications in the head region, without significant vascularity at the base, likely arising from the layer 2 of the gastric mucosa (Figure 1C and D). Hot snare polypectomy was performed after the application of an endoloop (Figure 1E-G). The postoperative period was uneventful, and the patient was discharged the following day. Histopathological and immunohistochemical examinations revealed a gastrointestinal stromal tumor with R0 resection (Figure 2A-C). She remains on follow-up without bleeding or recurrence. Calcification within gastric lesions is uncommon but is a valuable diagnostic indicator. The tumor location and calcification pattern help narrow the differential diagnosis.
Payila Satya Raghava Aneesh1, Venkatesh Vaithiyam2*, Surbhi Goyal3, Ashok Dalal4 (Sun,) studied this question.