J Gastric Cancer.  2011 Sep;11(3):189-193. 10.5230/jgc.2011.11.3.189.

Early Gastric Cancer with Signet Ring Cell Histology Remained Unresected for 53 Months

• Lee SS
• Ryu SW
• Kim IH
• Sohn SS

• KMID: 2055518
• DOI: http://doi.org/10.5230/jgc.2011.11.3.189

Abstract

The natural course of untreated patients with signet ring cell carcinoma of the stomach remains poorly understood while assumptions have been made to distinguish it from other types of gastric cancer. A 74-year-old Korean woman was diagnosed with early gastric cancer with signet ring cell histology and refused surgery. A satellite lesion was identified 46 months after the initial diagnosis. The patient finally agreed to undergo distal subtotal gastrectomy 53 months following the initial diagnosis. Postoperative histological examination of both lesions confirmed signet ring cell carcinoma associated with submucosal invasion. There was no evidence of lymph node metastasis.

Keyword

Disease progression; Gastrectomy; Carcinoma, signet ring cell; Stomach neoplasms

MeSH Terms

Aged
Carcinoma, Signet Ring Cell
Disease Progression
Female
Gastrectomy
Humans
Lymph Nodes
Neoplasm Metastasis
Stomach
Stomach Neoplasms

Figure

• 

  Fig. 1 Endoscopic images of the main lesion (single arrow) and the satellite lesion (double arrows) of early gastric cancer. The images were taken December 2005, when the initial diagnosis was made (A), subsequently on October 2006, 10 months after the diagnosis (B), on October 2009, 46 months after the diagnosis (C), and on March 2010, 51 months after the diagnosis (D).

• 

  Fig. 2 The resected specimen in May 2010. The main lesion (single arrow) of type IIb early gastric cancer, 3.0×4.5 cm in size, was located in the anterior wall of the distal body of the stomach. The satellite lesion (double arrows) of a type IIb early gastric cancer, 2.0×2.5 cm in size, was located in the greater curvature of the distal body of the stomach. The two lesions were separated by normal mucosa. (A) Specimen. (B) Main lesion. (C) Satellite lesion.

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  Fig. 3 Histopathologic findings. (A) The histopathologic findings of the main lesion were consistent with submucosal infiltration of tumor cells (H&E, ×200). (B) The tumor cells from the main lesion showed signet ring cell components (×400). (C) The histopathologic findings of the satellite lesion also showed submucosal infiltration of tumor cells (×200). (D) The tumor cells from the satellite lesion showed signet ring cell components as well (×400).

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