Metastatic Disease in the Stomach.

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.