Published online Nov 15, 2017. doi: 10.4251/wjgo.v9.i11.452
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
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.
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.