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A 67-year man presented with repeated vomiting, epigastric pain, and weight loss was admitted to the endoscopy unit. The patient underwent upper digestive endoscopy. The scope revealed a large amount of food and fluid in the stomach and some in the esophagus. Also, the scope revealed ulcerations and laceration, edema of the esophageal mucosa ( effect of gastric juice, fluid, and food on the esophageal mucosa from gastric outlet obstruction). The scope also showed a large cauliflower mass involving the incisura and pyloric ring. Despite the pyloric ring is anatomically opened, it is functionally closed, maybe due to the mass is pressing on the pyloric opening, and the mass is harder in comparison to the normal gastric tissue ( presence of excess food and fluid despite fasting more than 12 hours). What is your endoscopic diagnosis? What is your plan of treatment?
