Importance of Optical Diagnosis in Early Gastric Cancer: A Case Report of Early Gastric Signet Ring Cell Carcinoma

Abstract

Gastric signet ring cell carcinoma (SRCC) is a rare form of highly malignant adenocarcinoma. It is an epithelial malignancy characterized by the histologic appearance of more than 50% of cells as signet ring cells filled with mucin. The incidence of SRCC is rising,[1,2] therefore, the diagnosis of these cancers in the early stage is important as it is the only stage that curative measures can be done. A 49‑year‑old female was hospitalized due to epigastric pain, postprandial bloating for 3 months. Upper gastrointestinal endoscopy with narrow band imaging (NBI) showed 1.5 cm lesion in the lesser curvature of the stomach with irregular pit pattern and accentuated vascularization of the surrounding mucosa. Histopathology confirmed the presence of more than 50% of the cells as signet ring cells. We report on the importance of optical diagnosis in early gastric cancer with the help of NBI, the subsequent patient management, and prognosis.

Keywords: Gastric cancer, narrow band imaging, signet ring cell carcinoma