Abstract
Gastrointestinal clear cell sarcomas (GICCSs) are malignant mesenchymal tumour that occur in the wall of gastrointestinal tract, mostly in the ileum and rarely in the rectum. These tumours are highly invasive, and often have metastasized via the lymphatic system or bloodstream by the time of diagnosis. In this case, the patient was admitted for gastric fundus mass, who was subsequently found and confirmed by biopsy as clear cell sarcoma of rectum. Computed tomography (CT) and magnetic resonance imaging (MRI) showed multiple metastatic lesions in lymph node, lung, liver and bone. Furthermore, energy spectrum CT was used to confirm that the nature of gastric fundus mass and rectal lesion were consistent. So, this case may be multiple clear cell sarcomas in the rectum and stomach or clear cell sarcoma in the rectum with gastric fundus metastasis. Unfortunately, after several days of immunotherapy, the patient died due to abnormal liver function. At present, GICCS mainly relies on surgical resection, and the effect of radiotherapy and chemotherapy is not good. Therefore, how to find lesions as earlier as possible and make accurate diagnosis is particularly important. CT and MRI are essential examinations in the diagnosis of tumors. Whether they are helpful for the diagnosis of GICCS is the focus of our attention.