Kadakia S C, Parker A, Canales L
Department of Medicine, Brooke Army Medical Center, San Antonio 78234-6200.
Am J Gastroenterol. 1992 Oct;87(10):1418-23.
Metastatic tumors to the upper gastrointestinal tract were identified by esophagogastroduodenoscopy in 14 patients. Malignant melanoma, breast cancer, and lung cancer were the most common primary cancers in four, three, and three patients, respectively. Osteogenic sarcoma, renal cell carcinoma, Meckel cell carcinoma of the skin, and germ-cell tumor were the primary cancer in the remaining four. The esophagus was involved in three patients, the stomach in 13, duodenum in four, and papilla of Vater in one. Upper gastrointestinal bleeding and anemia were the most common presenting features. There was correlation between symptoms and endoscopic findings in all patients. Involvement of gastrointestinal tract at endoscopy was the initial and only evidence of metastases in all patients without evidence of metastases elsewhere, as evidenced by other diagnostic tests in any of these patients. Endoscopic biopsies and/or brush cytology provided histologic diagnosis in all 14 patients. The endoscopic and nonendoscopic literature regarding metastases to the upper gastrointestinal tract is reviewed.
通过食管胃十二指肠镜检查确诊了14例发生上消化道转移瘤的患者。恶性黑色素瘤、乳腺癌和肺癌分别是4例、3例和3例患者最常见的原发癌。其余4例患者的原发癌分别为骨肉瘤、肾细胞癌、皮肤默克尔细胞癌和生殖细胞肿瘤。3例患者食管受累，13例患者胃受累，4例患者十二指肠受累，1例患者 Vater 乳头受累。上消化道出血和贫血是最常见的临床表现。所有患者的症状与内镜检查结果之间均存在相关性。在内镜检查中发现胃肠道受累是所有未发现其他部位转移证据患者转移的初始且唯一证据，这些患者的其他诊断检查也证实了这一点。内镜活检和/或刷检细胞学检查为所有14例患者提供了组织学诊断。本文回顾了关于上消化道转移的内镜及非内镜文献。
