An incidentally found mass on the remnant stomach after a Roux-en-Y gastric bypass.

Abstract

Background: Incidentally found masses are a widely discussed area of medicine, and there are conflicting opinions as to how to deal with these findings, particularly in the stomach-which has limited documentation in the literature. Here we present a middle-aged female who was found to have an incidentally found mass on her remnant stomach 10 years after a Roux-en-Y gastric bypass (RYGB) surgery.

Case presentation: We present the case of a 66-year-old female who is 10 years post-op from a RYGB. After a bout of self-resolving diarrheal illness prompted a computed tomography (CT) scan in the emergency department, she was diagnosed with a 9-cm mass on her remnant stomach that after resection was found to be a gastrointestinal stromal tumor (GIST) with the PDGRRA p.D842V gene mutation.

Conclusion: The National Comprehensive Cancer Network (NCCN) outlines guidelines for the workup of abdominal masses. While endoscopic ultrasound is a common step in diagnosis of gastric masses, for a patient who has had a RYGB, access to the remnant stomach, which is no longer a part of the alimentary tract, is not possible. Thus, this patient's mass was surgically resected. Given the low risk of recurrence, her future care consists of follow-up with medical oncology in accordance with the NCCN guidelines.