Clinical Presentation

A 70-year-old man presents to the gastroenterology clinic with weight loss, nausea, and vomiting.

(A) Axial contrast-enhanced computed tomography (CT) shows an enhancing polypoid mass (arrow) extending into the lumen of the jejunum from a point of attachment to the bowel wall (arrowhead). (B) Coronal image shows an enhancing mass within the left lobe of the liver (arrow) in addition to the jejunal mass (arrowhead) with low-density central necrosis.

Differential Diagnosis

• Gastrointestinal stromal tumor (GIST): This is the most likely diagnosis, indicated by a heterogeneous, lobulated polyp with regions of low attenuation after contrast administration.

• Primary small-bowel adenocarcinoma: