P1044 - A Rare Case of Urothelial Cancer Metastasizing to the Stomach

Tanuj Sharma, MD¹, Mustafa Alani, MD², Brett Hughes, MD¹, Hadiatou Barry, MD¹, Savio Reddymasu, MD^1
1St. Joseph's Hospital and Medical Center, Creighton University School of Medicine, Phoenix, AZ; ²Creighton University/St. Joseph's Medical Center, Phoenix, AZ

Introduction: Stomach is a very rare site for metastasis. Some of the neoplasms metastasizing to stomach include primary breast, lung, melanoma, head/neck, uterus, colorectal, and kidney cancer. Here we present a case of urothelial cancer metastasizing to the stomach.

Case Description/Methods: A 77-year-old male with a history of bilateral lung transplant for COPD and urothelial cancer treated with cystoprostatectomy with ileal conduit and actively receiving radiation therapy was admitted with intractable nausea, vomiting, and aspiration pneumonia. Upper gastrointestinal study with gastrografin revealed distended stomach with markedly delayed passage of the contrast beyond the proximal duodenum. Esophagogastroduodenoscopy was eventually performed that showed the presence of several sessile polypoid lesions in the gastric antrum. The largest polpy was about 10 mm (Figure 1). In addition, a dilated duodenal bulb with a tight stricture at the junction of first and second part of the duodenum was also visualized. The largest antral polyp was removed by hot snare polypectomy and an uncovered self-expanding metal stent was placed across the stricture. Pathology of the gastric polypoid lesion showed GATA-3, p63, CK7, and CK20 positivity consistent with metastatic urothelial cancer. Due to deteriorating health, the patient was eventually discharged to home with hospice care.

Discussion: To the best of our knowledge this is the first case of urothelial cancer metastasizing to the stomach. This case highlights the importance of adequate tissue sampling of gastric polyps and performing immunohistochemistry analysis in patients with known history of neoplasm.


Figure: Figure 1: Endoscopic view of the 10mm polypoid lesion in the stomach resected with a hot snare.


Disclosures:
Tanuj Sharma indicated no relevant financial relationships.
Mustafa Alani indicated no relevant financial relationships.
Brett Hughes indicated no relevant financial relationships.
Hadiatou Barry indicated no relevant financial relationships.
Savio Reddymasu indicated no relevant financial relationships.


Tanuj Sharma, MD¹, Mustafa Alani, MD², Brett Hughes, MD¹, Hadiatou Barry, MD¹, Savio Reddymasu, MD¹. P1044 - A Rare Case of Urothelial Cancer Metastasizing to the Stomach, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.