P0580 - Metastatic Cancer to the Gastrointestinal Tract: A Single Center Case Series of Rare Occurrences Documented by Endoscopy

Kimberline Chew, MD, Lawrence Brandt, MD, MACG, Daniel Behin, MD
Montefiore Medical Center, Bronx, NY

Introduction: Cancers most commonly metastasize to the lymph nodes, liver, and lungs. Metastases to the hollow gastrointestinal tract (HGIM) are rare but can present at the time of primary diagnosis or many years later. HGIM often presents with non-specific symptoms and variable endoscopic manifestations that require tissue biopsy with histologic confirmation, which can potentially delay definite diagnosis and treatment. We report a case series of 5 patients from a single center who were diagnosed with HGIM from different primary tumor locations.

Case Description/Methods: We describe 5 patients with HGIM diagnosed by endoscopy at a single tertiary care center. Patient charts were reviewed for age of diagnosis, gender, type of primary tumor, ages at which the primary tumor and metastatic GI sites were found, symptoms of HGIM, and endoscopic findings. Each patient had a different primary tumor site – breast, lung, prostate, bile duct and bladder. At the time of diagnosis of HGIM, 3 patients had abdominal pain, 3 patients had decreased appetite, 1 patient had worsening anemia and 1 patient had intermittent rectal bleeding (Table 1). 3 patients had died, succumbing to their metastatic cancers. 60% were women. The mean age at diagnosis of the primary tumor was 56.8 ± 5.0 years, and the mean age at diagnosis of HGIM was 59.0 ± 5.2 years. The duodenum and colon were the most common sites of HGIM (40% each), followed by the stomach (20%) (Image 1). The average interval between the initial diagnosis of cancer and a diagnosis of HGIM was just over 2 years; all the patients had known cancer prior to endoscopy.

Discussion: The most common extra-abdominal tumors reported to metastasize to the GI tract are lung and breast cancers, with 4.7%-14% and 8%-35% of cases respectively. 2.5% of prostate cancers metastasize to the GI tract. Only seven cases of colonic metastases from cholangiocarcinoma have been described in the literature. Only about 16 cases of bladder metastasis to the GI tract have been reported. Although rare, GI metastasis should be considered for any patient with an underlying cancer diagnosis who presents with GI symptoms, even if non-specific. Given the increased survival of cancer patients with current therapeutic regimes, it is anticipated that there will be an increased occurrence of unusual presentations of metastatic disease, including involvement of the GI tract. Recognizing the range of possible presentations is important for early diagnosis and treatment.




Disclosures:


Kimberline Chew, MD, Lawrence Brandt, MD, MACG, Daniel Behin, MD. P0580 - Metastatic Cancer to the Gastrointestinal Tract: A Single Center Case Series of Rare Occurrences Documented by Endoscopy, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.