PDF(Pubmed)
Abstract：
Gastric carcinoma is the fifth most common and the third leading cause of cancer deaths worldwide. The incidence of diffuse-type gastric cancer, of which signet ring cell carcinoma is a subtype, is rising in the world. Due to non-specific gastritis-like symptoms, difficulty in assessing true tumor characteristics owing to its horizontal spread, and non-distinguishable endoscopic appearance from other gastric pathologies, the diagnosis of this subtype is challenging. We present a case of a 67-year-old woman with progressively worsening abdominal pain who came for an endoscopic ultrasound evaluation of an incidentally noted pancreatic cyst on a previous MRI. During endoscopy, a 1-cm gastric ulcer was noted along the lesser curvature of the gastric body. Biopsy confirmed a diagnosis of gastric signet ring cell carcinoma (SRCC) with CDX-2 and keratin positivity. The patient underwent total gastrectomy with Roux-en-Y reconstruction. Gross specimen revealed a diffuse SRCC invading the muscularis propria, along with lymphovascular and perineural invasion. In the context of our case, we discuss the morphological features of SRCC and the effectiveness of treatment options based on existing literature. Early accurate diagnosis and staging play an important role in determining treatment options as well as the clinical course of gastric SRCC.
摘要：
胃癌是全球癌症死亡的第五大最常见和第三大原因。弥漫型胃癌的发病率，印戒细胞癌是一种亚型，在世界上崛起。由于非特异性胃炎样症状，由于其水平扩散，难以评估真实的肿瘤特征，和其他胃病无法区分的内窥镜外观，该亚型的诊断具有挑战性.我们介绍了一例67岁的女性，腹痛逐渐恶化，她在先前的MRI上对偶然发现的胰腺囊肿进行了内窥镜超声评估。在内窥镜检查期间，沿着胃体的较小曲率观察到1厘米的胃溃疡。活检证实了CDX-2和角蛋白阳性的胃印戒细胞癌（SRCC）的诊断。患者接受了Roux-en-Y重建的全胃切除术。大体标本显示弥漫性SRCC侵入固有肌层，连同淋巴血管和神经周浸润。在我们的案例中，我们在现有文献的基础上讨论了SRCC的形态学特征和治疗方案的有效性。早期准确的诊断和分期在确定治疗方案以及胃SRCC的临床过程中起着重要作用。
