Signet ring cell early gastric cancer presenting as an elevated lesion

Hirano, Toshio; Yamaguchi, Shinya; Kusano, Hiroyuki; Miyashita, Kosei; Miura, Toshio; Chijiwa, Hideo; Morinaga, Masafumi; Shimoyama, Takatoshi; Nakagoe, Tohru; Shimizu, Teruhisa; Tomita, Masaru

doi:10.1007/bf02779364

Cited by 16 publications

(3 citation statements)

References 3 publications

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“…Gastric SRCC is usually flat or depressed; however, there are rare cases of elevated lesions that have been successfully resected [ 5 ]. Two causes of elevated lesions include upwards tumor growth into the gastric lumen and coexistent desmoplastic or fibrotic reaction [ 7 ]. However, neither of these reasons was applicable in the case we report here.…”

Section: Discussionmentioning

confidence: 99%

Gastric Signet-Ring Cell Carcinoma That Presented as an Elevated Lesion due to Fibromuscular Obliteration in the Lamina Propria

Misumi

Ichihara

Nonaka

et al. 2021

Case Reports in Gastrointestinal Medicine

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The widespread use of Helicobacter pylori eradication therapy in recent years has reduced the H. pylori infection rate, indicating that gastric cancer cases diagnosed in the future may be H. pylori-naïve. The typical endoscopic presentation of signet-ring cell carcinoma, which accounts for the majority of H. pylori-naïve gastric cancer cases, is a discolored, flat, or depressed lesion; it is rarely presented as an elevated lesion. In this study, we treated a patient with elevated signet-ring cell carcinoma in an H. pylori-naïve stomach. Histopathological testing after endoscopic submucosal dissection showed proliferation of fibromuscular tissue in the tumor, which may have caused the formation of the elevated lesion.

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Section: Discussionmentioning

confidence: 99%

Gastric Signet-Ring Cell Carcinoma That Presented as an Elevated Lesion due to Fibromuscular Obliteration in the Lamina Propria

Misumi

Ichihara

Nonaka

et al. 2021

Case Reports in Gastrointestinal Medicine

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“…Only two cases of early elevated‐type gastric SRCC have been reported with English abstracts to arise via this mechanism 4,7 (Table 1). Both cases in Table 1 showed morphological features of medullary carcinoma, in which signet ring cells formed an elevated lesion as a mass, but proliferated without preservation of the ductal structure.…”

Section: Discussionmentioning

confidence: 99%

Pedunculated Gastric Signet Ring Cell Carcinoma

Oku

Ono

Nagamachi

et al. 2007

Digestive Endoscopy

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Signet ring cell carcinoma (SRCC) is characterized by poor ductal formation and a diffuse progression pattern and generally presents as a depressed lesion in the majority of cases. We describe here an extremely rare case of gastric SRCC that presented as a pedunculated lesion. We hypothesize that the major factor responsible for the elevation of this lesion was proliferation of signet ring cells that did not lose their mutual connections. Among the two cases of early elevated-type gastric SRCC that have been reported in the literature, this is the first case of pedunculated intramucosal SRCC. Pathological examination revealed no cancer cells in the basal part of the elevated lesion. The cellular morphology was consistent with SRCC, although the ductal structure was well preserved and more similar to well-differentiated adenocarcinoma. Endoscopic examination showed a smooth-surfaced lesion with no depressed region around the basal part of the elevated lesion. Because these findings differ significantly from previous reports of elevated SRCC, this report provides further insight into the nature of SRCC.

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“…It usually demonstrates a depressed appearance and rarely presents as an elevated form. Hirano et al previously described a case of elevated‐type early gastric cancer composed of signet ring cell 3 . They explained that signet ring cell carcinoma easily erodes and thus naturally tends to form a depressed lesion, most likely owing to its lack of cell linkage.…”

Section: Discussionmentioning

confidence: 99%

Pedunculated gastric carcinoma demonstrating a gastric foveolar phenotype

Tanaka¹,

Ito²,

Harada³

et al. 2002

Digestive Endoscopy

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sonography and endoscopic ultrasonography demonstrated only a fatty liver except for the gastric polyp. There were no previous findings of either tumor invasion or lymph node metastasis. A surgical operation was therefore performed. The pathological findings showed a pedunculated lesion measuring 2.4 ¥ 1.8 cm, which was located in the fornix of the stomach. The histological findings showed a mixture of very well differentiated adenocarcinoma and poorly differentiated adenocarcinoma containing signet ring cells. The very well differentiated adenocarcinoma cells mimicked gastric foveolae (Figs 3a,b). The carcinoma cells were confined to the mucosa. No lymph node metastasis was observed. Immunohistochemically, both the very well differentiated and poorly differentiated components were diffusely and strongly positive for MUC5AC (Fig. 3c) and human gastric mucin (HGM), but negative for MUC2 (Fig. 3d) and CD10. These features therefore indicated gastric-type adenocarcinoma. DISCUSSIONSignet ring cell type tumors of the stomach are relatively rare. Maehara et al. reported that they make up only 3.4% of all gastric cancers. 2 Gastric adenocarcinoma with signet ring cells commonly shows poor differentiation. It usually demonstrates a depressed appearance and rarely presents as an elevated form. Hirano et al. previously described a case of We report a case of gastric cancer complicated with very well differentiated adenocarcinoma containing signet ring cells. An endoscopic examination revealed a pedunculated polyp in the fornix of the stomach. A surgical operation was performed and the pathological findings showed very well differentiated adenocarcinoma mimicking gastric foveolae with a poorly differentiated component containing signet ring cells. This is the first case of pedunculated gastric cancer complicated with very well differentiated adenocarcinoma containing signet ring cells and also demonstrating a gastric foveolar phenotype.

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Signet ring cell early gastric cancer presenting as an elevated lesion

Cited by 16 publications

References 3 publications

Gastric Signet-Ring Cell Carcinoma That Presented as an Elevated Lesion due to Fibromuscular Obliteration in the Lamina Propria

Gastric Signet-Ring Cell Carcinoma That Presented as an Elevated Lesion due to Fibromuscular Obliteration in the Lamina Propria

Pedunculated Gastric Signet Ring Cell Carcinoma

Pedunculated gastric carcinoma demonstrating a gastric foveolar phenotype

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