Successful gel immersion endoscopic mucosal resection for gastric metastasis from a renal cell carcinoma

An 81-year-old woman status-post radical right nephrectomy for renal cancer ten years ago and pancreatectomy for pancreatic metastasis six years earlier, exhibiting no recurrence thereafter, presented with abdominal discomfort. Esophagogastroduodenoscopy showed a 10 mm erythematous polyp in the greater curvature of the gastric body (Fig. 1a). Magnifying endoscopy with narrow-band imaging showed intervening part enlargement and a partially absent microsurface pattern (Fig. 1b). Histopathological examination of biopsy revealed metastatic renal cell carcinoma (RCC). No evidence of metastatic lesions to other organs was found. Gel immersion endoscopic mucosal resection (EMR) using Viscoclear (Otsuka Pharmaceutical Factory, Tokushima, Japan) was performed. We achieved en bloc resection using a 10 mm snare (CaptivatorⅡ, Boston Scientific, Marlborough, MA, USA) (Fig. 1c, d).