Metastatic gastric cancer arising from breast carcinoma: Endoscopic ultrasonographic aspects

Linitis plastica of the stomach was diagnosed in four patients. Endoscopic ultrasonography (EUS) was performed in four cases; they were monitored by E US and had their treatment adapted accordingly, According to the present st udy, the typical criteria of gastric linitis at EUS are: (a) rigidity of th e gastric wall; (b) a wall thickness exceeding 6 mm; (c) a second enlarged layer marginally more echogenic than the fourth hypoechogenic layer (muscul aris propria); (d) a third hyperechogenic enlarged layer; and (e) a poor de marcation between layers. Gastric linitis appears more likely to be specifi c metastasis from lobular breast carcinoma. In most of the follow-up cases, EUS showed correlation with a subsequent decrease of the CA15.3 level. At present, EUS seems to be the most effective and least invasive examination for clinical diagnosis and treatment surveillance of secondary gastric lini tis arising from infiltrating lobular carcinoma (ILC) of the breast.