Background and Study Aims: There have been several published reports on metastatic lesions in the stomach, but the numbers of cases have been limited due to the low frequency of the condition. The present study examined the clinicopathological features of metastatic tumors in the stomach from distant sites in a large series of cases.
Patients and Methods: A total of 389 patients with gastric metastases from solid malignant tumors were examined between 1968 and 1998 at our institution. Of these, 347 were identified from a series of 6380 autopsy cases; 54 patients were diagnosed endoscopically while alive, 12 of whom had confirmation of the condition at autopsy.
Results: In the endoscopically diagnosed cases, the metastases presented as solitary (65 %) or multiple lesions (35 %), and were more frequently located in the middle or upper third of the stomach. Although the endoscopic appearance often resembled that of submucosal tumor (51 %) or primary gastric cancer (39 %), the final diagnosis was easily obtained in over 90 % of cases from endoscopic biopsies. In two cases of lung cancer and breast cancer, gastric metastases were found before the primary tumors. In the autopsy cases with solid malignancies, metastatic lesions to the stomach were found in 5.4 %, and the lung, breast, and esophagus were common primary sites. Malignant melanoma was the most frequent tumor to metastasize to the stomach (29.6 %).
Conclusions: Since metastatic lesions to the stomach are rare, the above characteristics of the lesions should be borne in mind, and biopsies should be taken for precise diagnosis during endoscopic examinations.
References
-
1
Davis G H, Zollinger R W.
Metastatic melanoma of the stomach.
Am J Surg.
1960;
99
94-96
-
2
Higgins P M.
Pyloric obstruction due to metastatic deposits from carcinoma of the bronchus.
Can J Surg.
1962;
5
438-441
-
3
Menuck L S, Amberg J R.
Metastatic disease involving the stomach.
Am J Dig Dis.
1975;
20
903-913
-
4
Pomerantz H, Margolin H N.
Metastases to gastrointestinal tract from malignant melanoma.
Am J Roentgenol.
1962;
88
712-717
-
5
Scobie B A.
Malignant gastric ulcer due to metastasis.
Aust Radiol.
1966;
10
119-123
-
6
Richter R, Panish J, Berci G.
Endoscopic findings in melanoma metastatic to the stomach.
Gastrointest Endosc.
1972;
18
172-173
-
7
Morton W J, Tedesco F J.
Metastatic bronchogenic carcinoma seen as a gastric ulcer.
Am J Dig Dis.
1974;
19
766-770
-
8
Dick R.
Pattinson JN. Metastases to the stomach wall presenting as simple polyps.
Br J Radiol.
1972;
45
761-764
-
9
Japanese Gastric Cancer Association .
Japanese classification of gastric carcinoma: 2nd English edition.
Gastric Cancer.
1998;
1
10-24
-
10
Ries L AG, Wingo P A, Miller D S, et al.
The annual report to the nation on the status of cancer, 1973-1997, with a special section on colorectal cancer.
Cancer.
2000;
88
2398-2424
-
11
Saito T, Iizuka T, Kato H, et al.
Esophageal carcinoma metastatic to the stomach.
Cancer.
1985;
56
2235-2241
H. Kondo, M.D.
Dept. of Endoscopy and Gastrointestinal Oncology
National Cancer Center Hospital
5-1-1 Tsukiji, Chuo-ku
Tokyo 104-0045
Japan
Fax: Fax:+ 81-3-3542-3815
Email: E-mail:drkondo@syd.odn.ne.jp
