Tumorous gastric varices: Radiographic findings in 10 patients

PURPOSE: To determine the appearance of tumorous gastric varices on double- contrast barium studies and whether these varices have characteristic radio graphic features. MATERIALS AND METHODS: Review Of radiology files revealed 86 patients with gastric varices diagnosed during double-contrast upper gastrointestinal tra ct examinations. Of these 86 patients, 12 (14%) had a conglomerate mass of varices, or tumorous varices. Five of the 12 patients had proved gastric va rices and five were presumed to have varices on the basis of additional dia gnostic-test results, clinical follow-up findings, or both. Radiographs fro m these 10 patients were reviewed retrospectively to determine the size, lo cation, and morphologic features of these lesions. RESULTS: Tumorous varices had a mean size of 6.8 cm (range, 3-11 cm). They involved the posteromedial border of the gastric fundus in eight patients, the central cardiac region in one, and the anterolateral-inferior fundal bo rder in one. Viewed in profile, the varices appeared as smooth submucosal m asses with undulating contours and discrete borders. Viewed en face, the va rices manifested as a conglomerate of thickened, tortuous folds that faded peripherally into the adjacent mucosa. CONCLUSION: Tumorous gastric varices manifest as remarkably similar finding s an double-contrast barium studies, usually appearing en face as a conglom erate of thickened, lobulated folds and in profile as smooth, undulating, s ubmucosal masses on the posteromedial border of the gastric fundus. It is i mportant to be aware of the characteristic features of tumorous gastric var ices on double-contrast studies so that they are not mistaken for neoplasti c lesions in the stomach.