Cancer metastasis to the upper gastrointestinal tract-a case series

Background: Metastasis of non-gastrointestinal (non-GI) cancers to the upper GI tract is a rare occurrence, with limited cases reported in the literature. Recognising this type of metastasis is crucial, as it presents unique diagnostic and therapeutic challenges. This case series adds to the literature by discussing seven rare cases of non-GI cancer metastasising to the upper GI tract, emphasising the complications and clinical manifestations. These cases highlight the importance of early recognition and interdisciplinary management to optimise patient outcomes.

Case description: This retrospective series spans from 2016 to 2024 and includes seven consecutive patients from a tertiary hospital. The primary cancers include renal clear cell carcinoma, non-small cell lung cancer, prostate cancer, and melanoma. Each patient presented with unique patterns of metastasis to the GI tract, manifesting as complications such as upper GI bleeding, melaena, bowel perforation, abdominal pain and weight loss. Interventions ranged from gastroscopy and biopsy to surgical resection, and outcomes varied from disease control to progression with palliative interventions and fatality in some cases, despite targeted treatments. Follow-up of some of the cases highlights the difficulties in managing recurrent bleeding and perforation in these patients.

Conclusions: Metastasis of non-GI primary tumours to the upper GI tract-although rare, requires clinicians to maintain a high index of suspicion when encountering unexplained GI symptoms in patients with a history of malignancy. This case series highlights the diverse presentations and complications of upper GI metastasis from non-GI cancers and underscores the need for personalised management strategies. Early recognition and tailored interventions can improve patient outcomes and reduce morbidity.