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A 32-year-old Caucasian man presented with a 2-month history of fatigue, 4 kg weight loss and vague dyspepsia. He described no vomiting and no lower gastrointestinal symptoms. He was previously healthy with no significant past medical history, did not smoke and consumed around 10 units of alcohol per week. Systemic examination was normal. Blood tests revealed a mild normocytic anaemia (haemoglobin 128 g/l) with normal haematinics. Urea and electrolytes, liver function tests, calcium and c reactive protein were all within normal limits.
Upper gastrointestinal endoscopy revealed an unusual raised lesion in the second …