Case 167


A male patient, 52 years old, was referred to the Alfa Institute of Gastroenterology with chronic pain in the left upper abdomen for about 10 years, associated with bloating, early satiety and postprandial fullness. The patient reported diminished appetite and weight loss of approximately 20 kilograms during this period. On physical examination, the patient was slimmed, and the palpation presented a painful upper abdomen. An upper endoscopy suggested alteration of gastric morphology without alterations in the mucosa. The following imaging tests were done.

Based on the clinical picture and the images which one of the following is the most likely diagnosis and definitive therapy?

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