Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 24, 2024; 15(10): 1379-1382
Published online Oct 24, 2024. doi: 10.5306/wjco.v15.i10.1379
Gastric metastasis of small cell lung carcinoma: A rare but noteworthy entity to consider
Cemal Ugur Dursun, Ahmet Oguz Tugcu, Galip Dogukan Dogru
Cemal Ugur Dursun, Department of Radiation Oncology, Kartal Dr. Lutfi Kirdar City Hospital, İstanbul 34865, Türkiye
Ahmet Oguz Tugcu, Galip Dogukan Dogru, Department of Radiation Oncology, Gulhane Training and Research Hospital, Ankara 06010, Türkiye
Author contributions: Dursun CU, Tugcu AO and Dogru GD contributed to this paper; Dursun CU designed the overall concept and outline of the manuscript; Tugcu AO contributed to the discussion and design of the manuscript; Dogru GD contributed to the writing, and editing the manuscript, illustrations, and review of literature.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cemal Ugur Dursun, MD, Doctor, Department of Radiation Oncology, Kartal Dr. Lutfi Kirdar City Hospital, Cevizli, D-100 Güney Yanyol, İstanbul 34865, Türkiye. cudursun.ro@gmail.com
Received: August 13, 2024
Revised: September 12, 2024
Accepted: September 19, 2024
Published online: October 24, 2024
Processing time: 46 Days and 9.6 Hours
Abstract

Small cell lung carcinoma (SCLC) is an aggressive malignancy known for its propensity for early and extensive metastatic spread. Gastric metastasis, where cancer cells disseminate from the lung to the stomach, is a rare but increasingly recognized complication of SCLC. This review provides a comprehensive overview of gastric metastasis in SCLC, addressing its clinical significance, diagnostic challenges, management strategies, and prognosis. Additionally, it examines the broader metastatic patterns of SCLC and compares them with other malignancies known for gastric metastasis. Gastric metastasis in SCLC, though infrequent, is clinically significant and often indicates advanced disease with a poor prognosis. SCLC typically metastasizes to the liver, brain, bones, and adrenal glands, with the stomach being an unusual site. The incidence of gastric metastasis ranges from 1% to 5% in autopsy studies, although this may be underestimated due to diagnostic difficulties and asymptomatic early lesions. Diagnosing gastric metastasis presents several challenges, including the asymptomatic nature of many cases, limitations of conventional imaging techniques, and difficulties in distinguishing metastatic lesions from primary gastric cancer via endoscopy. Histopathological diagnosis requires careful examination to identify SCLC cells through their characteristic small cell morphology and neuroendocrine markers. Management of gastric metastasis in SCLC typically involves a multidisciplinary approach. Systemic therapy, primarily chemotherapy, remains the cornerstone of treatment, with palliative care addressing symptoms and complications. Surgical intervention is usually reserved for specific cases requiring symptomatic relief. The prognosis for patients with gastric metastasis from SCLC is generally poor, reflecting the advanced stage of the disease. Median survival is significantly reduced compared to patients without gastric metastasis. This review emphasizes the need for enhanced awareness and early detection to improve patient outcomes and highlights the importance of ongoing research into better diagnostic and therapeutic strategies.

Keywords: Lung cancer; Small cell lung cancer; Gastric metastasis; Metastasis; Rare metastasis

Core Tip: Gastric metastasis in small cell lung carcinoma is a rare but clinically significant complication, often indicative of advanced disease. Due to diagnostic challenges and the typically asymptomatic nature of early gastric lesions, this metastatic involvement may be identified late. A multidisciplinary approach, including systemic therapy and symptomatic management, is essential for optimal patient care.