Background: Gastric metastases are rare and represent a late and progressed stage of malignant disease. This review highlights epidemiological, clinical and endoscopic findings as well as therapeutic strategies for metastatic disease of the stomach. Summary: The clinical presentation of gastric metastases is highly unspecific. The endoscopic appearance of gastric metastases is heterogeneous, but the most prevalent findings are solitary and submucosal lesions in the gastric wall. The most prevalent primary tumor spreading to the stomach is breast cancer, followed by renal cell cancer and many others. In general, gastric metastases occur in a late stage of malignant disease and frequently indicate short survival. Specific therapy for gastric metastases does not exist and is mainly performed with chemotherapy according to the primary tumor. Compared with other metastatic diseases, gastric metastases of renal cell cancer and breast cancer need distinct consideration. Gastric metastasis of these cancers presents with a better prognosis, as patients with these conditions can be offered effective chemotherapeutic treatment. Key Message: Gastric metastatic disease is a rare clinical presentation. The pathophysiology of gastric metastatic seeding is not well understood. Practical Implications: In the course of malignant disease the presence of gastric metastases should be taken into account if mucosal or submucosal gastric lesions are present. Therapy in general depends on the primary tumor.

Keywords:
Endoscopic diagnosis, Gastric metastasis, Metastases, Stomach
1.
De Palma GD, Masone S, Rega M, Simeoli I, Donisi M, Addeo P, Iannone L, Pilone V, Persico G: Metastatic tumors to the stomach: clinical and endoscopic features. World J Gastroenterol 2006;12:7326-7328.
2.
Kobayashi O, Murakami H, Yoshida T, Cho H, Yoshikawa T, Tsuburaya A, Sairenji M, Motohashi H, Sugiyama Y, Kameda Y: Clinical diagnosis of metastatic gastric tumors: clinicopathologic findings and prognosis of nine patients in a single cancer center. World J Surg 2004;28:548-551.
3.
Namikawa T, Hanazaki K: Clinicopathological features and treatment outcomes of metastatic tumors in the stomach. Surg Today 2014;44:1392-1399.
4.
Eivazi-Ziaei J, Esmaili H: Metastatic malignant melanoma affecting stomach. J Cancer Res Ther 2014;10:733-736.
5.
Rana SS, Chaudhary V, Bhasin DK: Narrow band imaging appearance of gastric metastasis from malignant melanoma. Ann Gastroenterol 2013;26:353.
6.
Ozturk O, Basar O, Koklu S, Yuksel O, Purnak T, Sokmensuer C: An unusual presentation of malignant melanoma: amelanotic gastric metastasis. Am J Gastroenterol 2015;110:476.
7.
Kim GH, Ahn JY, Jung HY, Park YS, Kim MJ, Choi KD, Lee JH, Choi KS, Kim DH, Lim H, Song HJ, Lee GH, Kim JH: Clinical and endoscopic features of metastatic tumors in the stomach. Gut Liver 2014, Epub ahead of print.
8.
Kumcu E, Gonultas M, Unverdi H, Hucumenoglu S: Gastric metastasis of a renal cell carcinoma presenting as a polypoid mass. Endoscopy 2014;46(suppl 1 UCTN):E464.
9.
Shaaban H, Modi Y, Modi T, Guron G: Diffuse gastroduodenal metastasis from cutaneous malignant melanoma presenting as amelanotic ‘volcano-like' ulcers. J Gastrointest Cancer 2014;45:116-117.
10.
Oda I, Kondo H, Yamao T, Saito D, Ono H, Gotoda T, Yamaguchi H, Yoshida S, Shimoda T: Metastatic tumors to the stomach: analysis of 54 patients diagnosed at endoscopy and 347 autopsy cases. Endoscopy 2001;33:507-510.
11.
Sakurai K, Muguruma K, Yamazoe S, Kimura K, Toyokawa T, Amano R, Kubo N, Tanaka H, Yashiro M, Ohira M, Hirakawa K: Gastric metastasis from renal cell carcinoma with gastrointestinal bleeding: a case report and review of the literature. Int Surg 2014;99:86-90.
12.
Onorati M, Petracco G, Uboldi P, Redaelli DG, Romagnoli S, Albertoni M, Di Nuovo F: A solitary polypoid gastric metastasis 20 years after renal cell carcinoma: an event to be considered, and a brief review of the literature. Pathologica 2013;105:132-136.
13.
Sofos S, Azagra JS, Arru L, Ries F, Leider P, Weber J, Goergen M: Multidisciplinary management of a gastric metastasis of uveal melanoma presenting 12 years after enucleation. Bull Soc Sci Med Grand Duche Luxemb 2013;2:63-68.
14.
Mehrzad R, Agarwal A, Faller GT, Fiore JA: Prostate cancer metastasis to the stomach: 9 years after the initial diagnosis - case report and a literature review. J Gastrointest Cancer 2014;45(suppl 1):40-43.
15.
Kim YI, Kang BC, Sung SH: Surgically resected gastric metastasis of pulmonary squamous cell carcinoma. World J Gastrointest Surg 2013;5:278-281.
© 2015 S. Karger AG, Basel
2015
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.