ABSTRACT
A hematogenous or lymphogenous metastasis and a direct or disseminated invasion can occur in cases of a gastrointestinal metastasis. Moreover, a hepatic or peritoneal metastasis is common in advanced gastric cancer. However, a colonic metastasis, particularly an appendicular metastasis, is quite rare. Recently, we experienced a case with an appendicular submucosal tumor-like elevated lesion and multiple rectal elevated lesions during a colonoscopy in an advanced gastric cancer patient. The appendicular lesion was resected endoscopically and a biopsy of the rectal lesions was performed. The pathologic diagnosis was an appendicular and rectal metastasis of a signet ring cell carcinoma. We describe a case of appendicular and rectal metastasis from gastric cancer. The results highlight the importance of considering a metastatic carcinoma when an appendicular or rectal mass is found incidentally in a malignant neoplasm patient.