A 72-year-old man presents to his GP with increasing dyspepsia and weight loss. He has not experienced any other GI symptoms and physical examination is unremarkable. A barium meal is performed with the administration of intravenous Buscopan. The oesophagus is normal in appearance but a 'bull&;s eye' lesion is noted in the gastric mucosa. Which one of the following is not a recognised cause of this appearance?
Magenstrasse refers to the normal longitudinal mucosal folds seen adjacent to the lesser curve of the stomach during a barium meal. The 'bull&;s eye' appearance seen during a barium meal is due to a central ulcer in an elevated area of submucosa. A GIST may well have this appearance and neurofibromatosis can cause single or multiple target lesions. Melanoma is the commonest cause of submucosal gastric metastases.
Gastric carcinoma
Gastrointestinal stromal tumour (GIST)
Magenstrasse
Melanoma metastases
GIT and hepatobiliary system