Clinical and endoscopic aspects of metastases to the gastrointestinal tract

Abstract

Background Studies that describe metastases to the gastrointestinal (GI) tract are restricted to small case series. An increase in the frequency of this condition is expected, so it would be useful to better characterize the endoscopic aspects of metastasis to the GI tract. The aims of this study were to describe the frequency and endoscopic features of the lesions, and to analyze the survival rate after diagnosis of metastasis. Methods This was a retrospective, single-center, observational study, conducted between 2009 and 2017. Patients with metastasis to the GI tract were included. Results 95 patients were included. Melanoma (25.3 %), lung (15.8 %), and breast (14.7 %) were the most frequent primary tumors. The most common endoscopic presentation was a solitary, ulcerated lesion in the gastric body. Conventional biopsy was diagnostic in 98.9 % of the cases. The mean and median survival rates were 13.3 months (95 % confidence interval [CI] 8.2 – 18.3) and 4.7 months (95 %CI 3.7 – 5.6), respectively. Palliative treatment with chemo- and/or radiotherapy after the diagnosis of the metastasis was related to a higher survival rate. Conclusions Melanoma, lung, and breast cancer were the most common primary tumors to metastasize to the GI tract. The endoscopic features could not predict the primary site of the tumor. The finding of metastasis in the GI tract is related to the final stage of the cancer disease but patients who received palliative treatment with chemo- and/or radiotherapy after diagnosis of GI metastasis had higher survival rates.

A rare case of polypoid primary anorectal melanoma with subsequent giant stomach metastasis: a gastrointestinal involvement of both primary and metastatic mucosal melanoma

“…Regarding the metastatic involvement of the GI tract, the most common cancers implicated are melanoma, lung and breast cancer; in particular, the stomach is compromised in melanoma in about 20% of cases 6 . In the majority of events, the endoscopic presentation consists of a unique, nonpigmented, ulcerated lesion in the gastric body, where multiple biopsies are diagnostic; as it happened in our case 7 . Another manifestation consisted of pigmented non-ulcerated lesions.…”

“… 6 In the majority of events, the endoscopic presentation consists of a unique, non-pigmented, ulcerated lesion in the gastric body, where multiple biopsies are diagnostic; as it happened in our case. 7 Another manifestation consisted of pigmented nonulcerated lesions. Recently also endoscopic full-thickness resection was demonstrated feasible for gastric lesion; this option was not practicable in our patient due to the huge dimension of the gastric metastase.…”

Endoscopic diagnosis of gastric metastases from malignant melanoma: systematic review

“…This characteristic has been described earlier, 99 and recently by other authors. 3 , 97 , 100 The pathophysiological mechanism underlying the greater preference for involvement of the gastric body remains unknown.…”

Gastrointestinal involvement of primary skin diseases

“…GI metastasis of primary skin cancers is generally rare. In a retrospective, single‐centre, observational endoscopic study, melanoma, followed by lung and breast cancer, was the most common primary tumours to metastasize to the GI tract 69 . Single cases of GI metastasis originated from cutaneous Merkel cell carcinoma, 70 squamous cell carcinoma, 71 angiosarcoma and dermatofibrosarcoma have been reported 72,73 …”