Pseudokidney Sign in Gastric Cancer

TL;DR

A rare ultrasound sign called pseudokidney sign was found in a patient with gastric cancer, highlighting its potential as a diagnostic clue.

Contribution

This case report adds to the limited documentation of pseudokidney sign in gastric cancer.

Findings

Pseudokidney sign was observed in a gastric mass confirmed as adenocarcinoma.

The sign was associated with regional lymphadenopathy and distant metastases.

PKS may indicate gastrointestinal pathology and requires further diagnostic evaluation.

Abstract

Pseudokidney sign (PKS) is a characteristic sonographic finding of an abnormal mass with a reniform appearance, and a hyperechoic central region surrounded by a hypoechoic area. It has been seldom documented in gastric cancer. A 75-year-old male patient presented with a palpable abdominal resistance in the left upper abdominal quadrant and ultrasound evaluation revealed a well-vascularized mass presenting with PKS. Regional lymphadenopathy was also found, and the working diagnosis of gastric cancer was established. The suspected diagnosis was later verified endoscopically and on pathohistological examinations as gastric adenocarcinoma. Computed tomography staging also revealed distant metastases to the lungs, liver, and adrenal glands and abdominal lymphadenopathy. The PKS often indicates gastrointestinal pathology, and it may be seen in benign and malignant conditions due to gastrointestinal wall thickening. Therefore, additional diagnostic examinations are advised for a more definite diagnosis.

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