INTESTINE Vol.12 No.1(2-6-2)

Theme Mesenchymal neoplasms of the colon and rectum : excluding lymphoproliferative disorders
Title Metastatic tumors of large intestine
Publish Date 2008/01
Author Seiji Shimizu Department of Gastroenterology, JR West Osaka Railway Hospital
Author Wataru Fukuda Department of Gastroenterology, JR West Osaka Railway Hospital
Author Mika Mihara Department of Gastroenterology, JR West Osaka Railway Hospital
Author Yoko Kitaguchi Department of Gastroenterology, JR West Osaka Railway Hospital
Author Motoki Watanabe Department of Gastroenterology, JR West Osaka Railway Hospital
Author Hajime Honjo Department of Gastroenterology, JR West Osaka Railway Hospital
Author Yasuhide Mitsumoto Department of Gastroenterology, JR West Osaka Railway Hospital
Author Takahiro Mori Department of Gastroenterology, JR West Osaka Railway Hospital
Author Hideo Tomioka Department of Gastroenterology, JR West Osaka Railway Hospital
[ Summary ] Metastatic tumors in the large intestine are relatively rare. Metastases are established by direct invasion, peritoneal dissemination, or hematogenous / lymphatic spreading. Dissemination is the most frequent. As origins of metastasis, the stomach is the commonest, and the pancreas and the lungs follow. As radiological findings of metastatic lesions, tethering of folds is reported to be the most frequently seen condition. This finding, means the presence of dissemination. Submucosal tumor (SMT) like masses are usually formed where there has been hematogenous / lymphatic spreading, but may be the result of other metastatic patterns. Features of metastatic lesions which simulate SMTs include multiple lesions, slightly distorted contours, and central cavitation which is well known as “bull's eye appearance”, although they are not always observed. The echogenicity of metastatic tumors observed with endoscopic ultrasonography is similar to that of cancers and carcinoids, and is slightiy higher than that of non-epithelial tumors like lymphomas, myogenic tumors, gastrointestinal stromal tumor (GIST), and others. Recendy, metastatic lesions mimicking superficial type tumors have been recognized. Most of the origins of such lesions are gastric cancers.
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