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      Call for Papers: Current Management of Duodenal Neoplasia

      Submit here by March 31, 2025

      About Digestion: 3.0 Impact Factor I 7.9 CiteScore I 0.891 Scimago Journal & Country Rank (SJR)

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      “Homomorphic” Tumor Metastases as an Endodiagnostic Clue: A Case Series of Renal-Cell Carcinoma Metastatic to the Stomach

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          Abstract

          Distinguishing between a primary malignancy and a metastasis can be challenging in some cases. Herein, we describe 2 cases of gastric lesions that were endoscopically sampled and ultimately found to be metastatic from a renal-cell carcinoma. In both cases, the gastric metastases were endoscopically homomorphic to the primary organ (the kidney); i.e., grossly resembling and thus providing an endoscopic clue as to the primary tumor source. We report on the evaluation of obscure metastatic gastric involvement of malignancy and present the concept of homomorphism as a potential diagnostic clue in determining the source of unknown and often unsuspected primary malignancy.

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          Most cited references8

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          Clinicopathological features and treatment outcomes of metastatic tumors in the stomach.

          The metastasis of tumors to the stomach is rare, which underlies the clinical problems regarding their diagnosis and treatment. The present review summarizes the current knowledge regarding the clinicopathological characteristics, therapeutic strategies and outcomes for metastatic tumors in the stomach. The primary malignancies of the metastatic tumors in the stomach were most often breast cancers (27.9 %), followed by lung cancer (23.8 %), esophageal cancer (19.1 %), renal cell carcinoma (RCC; 7.6 %) and malignant melanoma (7.0 %). In cases of breast cancer and RCC as the primary malignancy, the median interval between the treatment of the primary tumor and diagnosis of the metastatic tumor in the stomach (IPM) was 50-78 and 75.6 months, respectively, highlighting the fact that the metastatic spread to the stomach may occur many years after the initial treatment of the cancer. In nine patients with metastatic gastric tumors arising from ovarian cancer, an endoscopic examination revealed submucosal tumors in six patients (66.7 %), with a median IPM of 30 months. Appropriate systemic treatment for these tumors is the preferred therapeutic strategy. Although solitary metachronous gastric metastasis several years after treatment of the primary tumor is an exceptionally rare event, surgical resection of metastatic gastric tumors may be recommended to control hemorrhaging or for selected tumors.
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            Metastatic tumors to the stomach: clinical and endoscopic features.

            To evaluate the clinical and endoscopic patterns in a large series of patients with metastatic tumors in the stomach. A total of 64 patients with gastric metastases from solid malignant tumors were retrospectively examined between 1990 and 2005. The clinicopathological findings were reviewed along with tumor characteristics such as endoscopic pattern, location, size and origin of the primary sites. Common indications for endoscopy were anemia, bleeding and epigastric pain. Metastases presented as solitary (62.5%) or multiple (37.5%) tumors were mainly located in the middle or upper third of stomach. The main primary metastatic tumors were from breast and lung cancer and malignant melanoma. As the prognosis of cancer patients has been improving gradually, gastrointestinal (GI) metastases will be encountered more often. Endoscopic examinations should be conducted carefully in patients with malignancies, and endoscopic biopsies and information on the patient's clinical history are useful for correct diagnosis of gastric metastases.
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              Hematogenous metastases to the stomach. A review of 67 cases.

              Metastatic tumors to the mucosa of the stomach are unusual occurrences that can cause clinical and pathologic problems in diagnosis. The authors report 67 cases from the files of the Veterans Administration Center at Houston. Ten cases were found on endoscopic biopsy and 57 at necropsy. Each patient endoscopically evaluated presented with upper gastrointestinal tract symptoms, including bleeding, abdominal pain, anorexia, and vomiting. At endoscopic examination, characteristic "volcano-like" ulcers were noted. Clinical gastrointestinal symptoms were present in 30 of the necropsy cases, and in four cases the gastric metastases led to the patients' deaths. Tumors primary in the lung accounted for most of the metastases (55%), followed by other gastrointestinal malignancies. A correct diagnosis is important to direct therapy and is facilitated by the characteristic clinical, endoscopic, and histologic findings.
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                Author and article information

                Journal
                GAT
                GAT
                10.1159/issn.2296-3774
                Gastrointestinal Tumors
                S. Karger AG
                2296-3774
                2296-3766
                2019
                October 2019
                12 September 2019
                : 6
                : 3-4
                : 147-152
                Affiliations
                [_a] aDepartment of Medicine, Palisades Medical Center, Hackensack University, North Bergen, New Jersey, USA
                [_b] bDepartment of Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA
                [_c] cDepartment of Internal Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA
                [_d] dDepartment of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
                [_e] eDivision of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA
                Author notes
                *Dr. James H. Tabibian MD, PhD, Olive View-UCLA Medical Center, 14445 Olive View Drive, 2B-182 Sylmar, CA 91342 (USA), E-Mail jtabibian@dhs.lacounty.gov
                Article
                502520 PMC6873029 Gastrointest Tumors 2019;6:147–152
                10.1159/000502520
                PMC6873029
                31768359
                c7c78ca3-36aa-45be-b852-4c03f7a718d3
                © 2019 S. Karger AG, Basel

                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.

                History
                : 24 July 2019
                : 01 August 2019
                Page count
                Figures: 5, Pages: 6
                Categories
                Case Report

                Oncology & Radiotherapy,Gastroenterology & Hepatology,Surgery,Nutrition & Dietetics,Internal medicine
                Gastric tumor,Metastatic lesion,Endoscopy,Renal-cell carcinoma

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