Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Nov 15, 2017; 9(11): 452-456
Published online Nov 15, 2017. doi: 10.4251/wjgo.v9.i11.452
Gastric metastasis from ovarian adenocarcinoma presenting as a subepithelial tumor and diagnosed by endoscopic ultrasound-guided tissue acquisition
Filippo Antonini, Liboria Laterza, Lorenzo Fuccio, Massimo Marcellini, Lucia Angelelli, Sonia Calcina, Corrado Rubini, Giampiero Macarri
Filippo Antonini, Giampiero Macarri, Department of Gastroenterology, A. Murri Hospital, Polytechnic University of Marche, Fermo 63900, Italy
Liboria Laterza, Endoscopy Unit, AUSL, Reggio Emilia 42121, Italy
Lorenzo Fuccio, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
Massimo Marcellini, Medical Oncology, Principe di Piemonte Hospital, Senigallia 60019, Italy
Lucia Angelelli, Medical Oncology, Mazzoni Hospital, Ascoli Piceno 63100, Italy
Sonia Calcina, Department of Gastroenterology, San Salvatore Hospital, University of L’Aquila, L’Aquila 67100, Italy
Corrado Rubini, Department of Biomedical Sciences and Public Health, Pathological Anatomy and Histopathology, Polytechnic University of Marche, Ancona 60126, Italy
Author contributions: All authors made equal contributions to this manuscript.
Institutional review board statement: Since this is not a clinical study, this case report was not reviewed by the institutional review board.
Informed consent statement: Written informed consent for endoscopic examinations was obtained from the patient.
Conflict-of-interest statement: The authors state that they have no conflicts of interest regarding this case report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Filippo Antonini, MD, Department of Gastroenterology, A. Murri Hospital, Polytechnic University of Marche, Ospedale “A. Murri”, Fermo 63900, Italy. filippo.antonini@sanita.marche.it
Telephone: +39-734-6252249 Fax: +39-734-6252252
Received: May 27, 2017
Peer-review started: June 1, 2017
First decision: July 10, 2017
Revised: July 19, 2017
Accepted: August 17, 2017
Article in press: August 17, 2017
Published online: November 15, 2017
Abstract

We describe an uncommon case of a patient with a metastatic adenocarcinoma of ovarian origin presented as a gastric subepithelial tumor (SET) and that was diagnosed by endoscopic ultrasound fine-needle biopsy (EUS-FNB). Malignant gastric lesions are rarely metastatic and the primary tumor is mainly breast, lung, esophageal cancer or cutaneous melanoma. Gastric metastasis from ovarian cancer is unusual, presenting synchronously with the primary tumor but also several years later than the initial diagnosis. From an endoscopic point of view, gastric metastasis does not present specific features. They may mimic both a primary gastric tumor or, less frequently, an SET. This case demonstrates the importance of EUS-FNB in distinguishing SETs and how this may alter treatment and prognosis.

Keywords: Metastasis, Subepithelial lesion, Gastric cancer, Ovarian, Endoscopic ultrasonography

Core tip: Gastric metastasis from ovarian cancer is unusual, either as synchronous with the primary tumor or appearing several years after its initial diagnosis. The diagnosis is challenging because of the low incidence, especially when gastric metastases present as a subepithelial tumor. This case emphasizes the crucial role of endoscopic ultrasound fine-needle biopsy in the differential diagnosis of this rare condition.