Antral Adenocarcinoma

Howard T Heller, MD
Ramin Khorasani, MD

September 8, 1997

Presentation

Imaging Findings

Contrast-enhanced computed tomography (CT) images demonstrate mild intrahepatic biliary dilatation with the proximal common bile duct measuring 8 mm. The distal common bile duct is not visible. The pancreas appears normal. A moderate amount of ascites is present in the upper abdomen.

The stomach is underdistended, but the gastric wall is diffusely thickened with a mass-like appearance toward the antrum (black arrows). This gastric mass abuts the anterior aspect of the mid common bile duct, likely accounting for the mild intrahepatic biliary dilatation (long white arrow).

Diffuse mesenteric and subcutaneous fat edema (short white arrow) is present, consistent with anasarca.

Differential Diagnosis

• Primary or metastatic neoplasms may have this appearance.
• Gastric wall thickening may also be seen in gastritis.
• Underdistension commonly causes apparent gastric wall thickening. However, images obtained after additional oral contrast can help to exclude this possibility.

Diagnosis

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