Abstract
A 62 year-old female with a history of smoking presented ith abdominal pain, melena, and cough for one month. She was ypotensive and tachycardic. Her haemoglobin was 9 g/dl. Esophgogastroduodenoscopy showed multiple odd-looking lesions in he mid-gastric body measuring 1.5 cm with heaped up edges and entral ulceration (Fig. 1). Similar lesions were noted throughout he duodenum. One of the lesions in proximal D2 had a large cenral ulceration and a prominent vessel in the base. Biopsy of the astric lesion showed poorly differentiated large cell carcinoma Fig. 2). Helicobacter pylori was not detected. Computed Tomogaphy/Positron Emission Tomography scan showed avid uptake in he left hilum, adrenal glands and numerous osseous and soft tisue lesions. The overall condition was consistent with lung cancer ith metastasis to the upper gastrointestinal tract. A similar picure might be seen with gastrointestinal stromal tumours which
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