Barium swallow shows a smooth, well-defined filling defect with a 'shouldering' appearance at the gastroesophageal junction. On CT, the mass is extraluminal, heterogeneous with central necrosis. The most likely diagnosis is:

• A Gastrointestinal stromal tumour (GIST) ✓
• B Squamous cell carcinoma of oesophagus
• C Achalasia cardia
• D Leiomyoma of oesophagus

Explanation

GIST of the gastroesophageal junction or stomach presents as a large exophytic/submucosal heterogeneous mass with central necrosis or cavitation, often with rim enhancement on CT. Barium shows smooth filling defect with 'shouldering' (abrupt margins as the mucosa is stretched over a submucosal mass). Oesophageal SCC shows irregular mucosal destruction. Leiomyoma is smaller, homogeneous, and densely enhancing. Achalasia shows dilated oesophagus with birds-beak narrowing.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.