Background: Gastric signet ring cell carcinoma (SRC) is a poorly differentiated adenocarcinoma in which the tumour cells invade singly or in small groups.The incidence of SRC has been reported in china as 13.9% (662 patients of 4,759) [1]. It is reported to occur more frequent among women and young patients.A regimen of epirubicin, cisplatin, and infused fluorouracil (ECF) improves survival among patients with incurable locally advanced or metastatic gastric adenocarcinoma.
Case presentation:A 38-year-old female presented with a 3 weeks history of epigastralgia. Her medical history was unremarkable. The endoscopic findings of the stomach revealed an infiltrative lesion, which the guided biopsy yielded a positive pathologic diagnosis of signet ring cell carcinoma. Diagnostic imaging with an abdominal computed tomography (CT) scan revealed a gastric thickening, with lymph nodes. Induction chemotherapy was recommended, based on 6 cycles of ECX (Epirubicin 50 mg/m 2 , Cisplatin 60 mg/m 2 , Capecitabine 625 mg/m 2 ). The total gastrectomy specimen showed a pathological complete response.The patient, who is always followed in consultation, is in complete remission 19 months after the diagnosis.
Conclusion:SRC is a distinctive histological type of gastric cancer. The ECX or EOX (epirubicin, oxaliplatine, capecitabine) remains the standard treatment of advanced primary gastric signet-ring cell carcinoma.Our case illustrates a complete pathologic response to ECX, which confirmed the effectiveness of this protocol on this histology.