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case_images: Esophagogastroduodenoscopy findings (white light and narrow band imaging). A subepithelial lesion with a 10-mm central umbilication with a loss of gland duct on the superficial depressed surface was identified.
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case_images: Although magnification did not show irregular epithelium or vessels at the margin around the lesions, loss of gland ducts was clearly observed on the superficial depressed surface (Figure 1).
case_images: Endoscopic ultrasonography findings (UM-3R and GF-UE260, Olympus). A solid and hypoechoic mass with hypervascularity on color Doppler imaging that proliferating mainly in the submucosal layer was found.
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case_images: A partial exposure of the tumor on the superficial layer was found (Figure 2).
case_images: Histological findings of biopsy specimen: (A) HE, (B) CD7, (C) CD20, (D) MIB-1, (E) Vimentin, (F) CD10. These findings suggested the gastric metastasis from clear cell renal cell carcinoma.
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case_images: Immunostaining (Figure 3) revealed negativity for all epithelial markers, (CK7, CK20, EMA, CK5/6, p63).
case_images: Computed tomography showed a large mass with early enhancement in the right kidney (C) with inferior vena cava invasion (B). In addition, metastatic lesion in the liver (A) and lung (D) also observed.
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case_images: Metastasis was suggested for a 10-mm mass observed in the right lung, S9 (Figure 4).