Abstract
The size and shape of intramucosal signet ring gastric cancer in this case remained endoscopically unchanged for 15 months. Laparoscopy-assisted distal gastrectomy was performed, and immunohistochemical analysis revealed Ki-67 and p53 mutations to be negative in this case. Signet ring gastric cancer has long been thought to confer a worse prognosis than other forms of gastric cancer; however, our case did not progress to advanced gastric cancer for 15 months.
Highlights
Signet ring cell gastric cancer (SRGC) is a histologic diagnosis based on microscopic characteristics as described by the World Health Organization [1]
SRGC evolves into advanced gastric cancer, the diffusely infiltrating characteristics of SRGC may involve the entire stomach, resulting in what is known as linitis plastica, which is associated with a poor prognosis [4]
Chromoendoscopy with indigo-carmine dye added to acetic acid improves the detection rates of early gastric cancer and precancerous lesions [11]
Summary
Signet ring cell gastric cancer (SRGC) is a histologic diagnosis based on microscopic characteristics as described by the World Health Organization [1]. SRGC evolves into advanced gastric cancer, the diffusely infiltrating characteristics of SRGC may involve the entire stomach, resulting in what is known as linitis plastica, which is associated with a poor prognosis [4]. The idea that signet ring cell histology conveys a worse prognosis might not always be correct. We report a rare case of SRGC in a male patient whose flat pale mucosal lesion was endoscopically unchanged 15 months after the initial endoscopic examination, when he was diagnosed with intramucosal SRGC
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