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Superficial Flat-Type Early-Stage Gastric Signet Ring Cell Carcinoma in the Atrophic Background Mucosa: Two Case Reports

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Abstract

Objectives

Gastric signet ring cell carcinoma is a rare and highly malignant adenocarcinoma, which is characterized by early metastasis, rapid progression and poor prognosis. Several studies have shown that early-stage gastric signet ring cell carcinoma may have equal or better prognosis than other types of gastric cancer. However, most of the early-stage lesions are difficult to detect by endoscopy. We aim to illustrate the difficulty of early detection of gastric signet ring cell carcinoma with mucosal atrophy.

Methods

The endoscopic and pathological features of two female cases were analyzed by upper gastrointestinal white light endoscopy combined with narrow-band imaging and endoscopic biopsy.

Results

Two female cases were diagnosed with early-stage gastric signet ring cell carcinoma with atrophic background mucosa occurring in the middle and lower part of the stomach. Both lesions less than 2.0 cm in diameter were surgically removed and identified as intramucosal adenocarcinoma.

Conclusion

We can roughly identify the demarcation of the lesion by combining white light endoscopy and narrow-band imaging, and slightly irregular microsurface and microvascular pattern of the lesion were found via magnifying endoscopic observation, but the demarcation can hardly be accurately identified.

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Funding

This case report is supported by Academic Leaders Training Program of Pudong Health Bureau of Shanghai (Grant No. PWRd2021-02) and the Fund from the Science and Technology Commission of Shanghai Municipality, China (Grant No. 19411951505).

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Authors and Affiliations

  1. Endoscopy Center, Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China

    Wenhua Wang, Yicheng Yang, Qinwei Xu, Li Zhang, Junyi Han & Jia Cao

  2. Endoscopy Center, Anqiu People’s Hospital, 159 Xuefu Road, Anqiu, 262100, Shandong, China

    Wenhua Wang

  3. Department of Pathology, Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065, China

    Shunli Wang

  4. Department of Gastroenterology, Weihai Central Hospital, 3 east Mishan Road, Weihai, 264400, China

    Renfang Yu

Authors
  1. Wenhua Wang
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  2. Yicheng Yang
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  3. Qinwei Xu
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  4. Shunli Wang
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  5. Li Zhang
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  6. Renfang Yu
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  7. Junyi Han
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  8. Jia Cao
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Contributions

JC: study concept and design, data interpretation, and technical support. WW: manuscript draft, data interpretation. YY: manuscript revision, data acquisition, and analysis. QX and SW: data acquisition and analysis. LZ and RY: data acquisition and analysis, technical support. JH: technical support. JC: final approval of the version to be published.

Corresponding author

Correspondence to Jia Cao.

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Written and informed consent was obtained from the patient to publish his data.

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The authors declare no competing interests.

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Wang, W., Yang, Y., Xu, Q. et al. Superficial Flat-Type Early-Stage Gastric Signet Ring Cell Carcinoma in the Atrophic Background Mucosa: Two Case Reports. J Gastrointest Canc 54, 677–681 (2023). https://doi.org/10.1007/s12029-022-00812-4

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  • DOI: https://doi.org/10.1007/s12029-022-00812-4

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