Occurrence of metastasis to the gastrointestinal tract (GIT) is rare. The studies on the endoscopic findings of metastatic tumors are usually restricted to small case series. As a consequence of the improved in the survival time for cancer patients over recent years, it is expected that progressively more cancer patients could present for diagnosis, by endoscopy, of secondary tumors of the GIT. With this regard, it would be useful to better characterize the endoscopic aspects of metastases to the GIT. observational study conducted in an oncological referral center between January 2009 and August 2017. The study included patients with metastasis to the GIT, submitted to endoscopic exam (upper gastrointestinal endoscopy, colonoscopy, enteroscopy, endoscopic ultrasound) with histological confirmation. Patients with lymphoma, leukemia, multiple myeloma, Kaposi sarcoma or direct invasion from adjacent organs were excluded. From January 2009 to august 2017, 53.675 endoscopic exams were performed. A total of 184 cases were suspected gastrointestinal metastasis. In 94 patients the diagnosis was confirmed. The baseline characteristics of the patients are summarized in Table 1. Common indications for endoscopy were abdominal pain (29 cases – 30.8%), gastrointestinal bleeding (28 cases – 29.8%) and vomiting (18 cases – 19.1%). The most common site of metastasis was the stomach (60 cases – 59.6%), followed by small bowel (29 cases – 29.8%) and colon (7 cases – 7.4%). Eight patients (8.5%) had metastasis in more than one site in the GIT. As indicated in Table 2, the most common primary malignancy was melanoma (25 cases – 26.6%), followed by breast (14 cases – 14.9%) and lung (14 cases – 14.9%). If considered just the gastric metastasis, the most common primary malignancy was melanoma (17 cases – 28.3%), breast (11 cases - 18.3 %) and lung (7 -11.3%). The most common endoscopic presentation of the metastatic lesions in the stomach was a solitary (32 cases – 53.3 %), ulcerated (31 cases – 51.6%) lesion located in the gastric body (75%). If considered just the small bowel metastasis the most common primary malignancy was lung (7 cases – 24.1%) and melanoma (7 cases – 24.1%) followed by breast (3 cases – 10.4%). The most common endoscopic presentation of the metastatic lesions in small bowel was the presence of a solitary (22 cases 84.6 %), polypoid (10 cases – 38.5%) lesion located in the second portion of duodenum (17 cases – 65.4%). Melanoma, breast and lung cancer were the most common metastasis to the GIT. The stomach was the main site of the metastatic lesions and the most common endoscopic presentation of stomach metastasis was solitary, ulcerated lesions in the gastric body. Despite the rarity of this condition, endoscopists should be aware of this differential diagnosis.Tabled 1Table 1 - Patients CharacteristicsNumber of patientsMale4952.1%Age (years)58.523 - 85Symptoms8388.3 %Dysphagia1111.7 %Weight Loss1313.8 %Bleeding2829.8 %Abdominal pain2930.8 %Nausea or vomiting1819.1 %Jaundice11.1 %Constipation11.1 %Asymptomatic1111.7 %Primary TumorNumber of patient%Head and neck55.3 %Esophagus55.3 %Uterus44.2 %Stomach55.3 %Breast1414.9 %Melanoma2526.6 %Ovary33.2 %Colorectal44.2 %Lung1414.9 %Kidney55.3 %Sarcoma33.2 %Merkel’s tumor11.1 %Duodenum11.1 %Indeterminate site11.1 %Hepatocellular11.1 % Open table in a new tab Tabled 1Table 2 – Endoscopic featuresOrganNumber of patients%Esophagus55.3 %Stomach6059.6 %Small Bowel2930.8 %Colorectal77.4 %Number of metastasisNumber of patients%Single6265.6 %2- 4 lesions1617.1 %> 5 lesions1718,1 %Size< 20mm3335.1 %20 - 50mm4042.5 %> 50mm2122.3 %AspectPolypoid2526.6 %Infiltrative2122.3 %Resembling early cancer1010.63 %Subepitelial33.19 %Ulcerated1718.1 %Ulcero-Infiltrative1819.4 % Open table in a new tab