Endoscopic features of metastatic tumors in the upper gastrointestinal tract

Abstract

Background and study aims: Metastatic tumors in the upper gastrointestinal tract are rare. The tumors that most frequently metastasize to the upper gastrointestinal tract are reported to be melanoma, lung cancer, and breast cancer. We describe here our experience in relation to the clinical manifestations and endoscopic findings of metastatic tumors in the upper gastrointestinal tract.

Patients and methods: Excluding leukemia, lymphoma, and direct tumor invasion, eight cases of metastatic tumor in the upper gastrointestinal tract from five identified primaries were observed over a period of eight years. The histological nature of the lesions was verified by endoscopic biopsy.

Results: The primary tumors in the eight cases were lung cancer (two cases), renal transitional-cell carcinoma (two cases), colonic cancer (two cases), melanoma (one case) and testicular embryonal cell carcinoma (one case). Acute upper gastrointestinal bleeding and anemia were the most common features of the clinical presentation, and the stomach and duodenum were the organs most often involved. Endoscopically, submucosal tumors and polypoid masses, with either erosion or ulceration, were the usual morphological findings.

Conclusions: Panendoscopy with histological examination is a way of identifying metastatic tumors to the upper gastrointestinal tract when patients have a known primary cancer and symptoms relating to the upper gastrointestinal tract. However, there is no specific information allowing the origin of a lesion to be predicted.