Japanese

Imaging Diagnosis of Metastatic Gastrointestinal Tumors Ikuko Iwashita 1 , Kyousuke Ushio 1 , Akinori Iwashita 2 1Department of Radiology, National Kyushu Cancer Center 2Department of Pathology, Fukuoka University Chikushi Hospital Keyword: 転移性腫瘍 , 消化管 , 粘膜下腫瘍 pp.647-662
Published Date 2004/4/24
DOI https://doi.org/10.11477/mf.1403100505
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 Among metastatic tumors, characteristics of true embolic metastasis(hamatoganeous and lymphatic metastasis)were mainly reviewed. Frequency of metastasis of malignant tumors to the gastrointestinal tract is as follows ; esophagus :1%, stomach :2.3~6%, small intestine :1.14~2.9%. Metastasis to the esophagus seemed to the least frequent. As for the origin of metastatic tumor, lung cancer and breast cancer were origins comparatively more frequent in every organ. In addition, gastric cancer, uterine cervical cancer and lingual cancer were origins frequent in the esophagus. Esophageal cancer and malignant melanoma in the stomach, malignant melanoma and renal cell carcinoma in the small intestine, and cervical cancer and esophageal cancer in the colon were frequent. As for clinical manifestation, dysphagea followed by anemia was the most frequent in the esophagus. Hematomesis and melena, weight loss, nausea and vomiting were frequent in the stomach. Melena and intestinal obstruction in the small intestine, and abdominal pain, abdominal distention and dyschezia were frequent in the colon. In a word, various manifestations characteristic to each organ were seen. Less than half of the cases had multiple lesions(esophagus :40%, stomach :47%, small intestine :34~37%, colon22%), however,83.3% of colonic lesions of superficial type had multiple lesions. As for macroscopic features, there were not only submucosal tumor-like lesions but lesions resembling the original cancer or malignant lymphoma. Frequency of submucosal tumor-like lesions was less than50%(esophagus :40%, stomach :43%, small intestine33.3%, colon :22.2~28.6%). The principal therapeutic procedure is an operation, but, as there are many cases having metastasis to other organs, chemotherapy is also frequently employed. Recently, less invasive treatment such as polypectomy or EMR has been employed for solitary metastatic lesions superficial in type, and cases in which progression has been delayed due to such treatment have been reported. Although the prognosis is generally poor, reports of cases who have survived for more than two years have recently increased. Therefore, delay of progression can be expected by early detection and intensive treatment.

 1) Department of Radiology, National Kyushu Cancer Center, Fukuoka, Japan

 2) Department of Pathology, Fukuoka University Chikushi Hospital, Fukuoka, Japan


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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