Rare endoscopic manifestation of pancreatic adenocarcinoma

Gastric metastasis from pancreatic cancer characterized by mucosal erosion: a case report and literature review

Pancreatic cancer with gastrointestinal tract metastasis is a fairly rare occurrence, and gastric metastasis in such cases has been seldom reported. We herein present a case of gastric involvement secondary to pancreatic cancer in a 74-year-old woman in whom the metastatic lesion only presented as mucosal erosion in the stomach. The patient had a 1-month history of progressive right upper quadrant pain before admission. Computed tomography and endoscopic examinations revealed a solid and hypo-enhancing mass in the head of the pancreas. The patient underwent conventional upper endoscopy before pancreatic biopsy, and mucosal erosion was observed in the gastric pylorus. We obtained gastric and pancreatic biopsies by gastroscopy and endoscopic ultrasound-guided fine needle aspiration, respectively. Pathologically, the biopsies taken from the area of gastric erosion showed poorly differentiated invasive adenocarcinoma that was morphologically consistent with the pancreatic specimens. Moreover, the gastric section showed tumor thrombi within the vessels. Hence, the suspected diagnosis was unresectable pancreatic cancer with gastric metastasis. The patient immediately underwent two courses of chemotherapy, but her condition rapidly deteriorated and she died 2 months later.