scholarly journals A Rare Initial Presentation of Gastric Cancer with Multiple Osteolytic Lesions

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Asad Jehangir ◽  
Kim Aderhold ◽  
Priya Rajagopalan ◽  
Oluwaseun Shogbesan ◽  
Sharon Swierczynski ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Carcinoma ◽  
Gastrointestinal Symptoms ◽  
The United States ◽  
Leptomeningeal Carcinomatosis ◽  
Unusual Complication ◽  
Elevated Alkaline Phosphatase ◽  
Osteolytic Lesions ◽  
Signet Ring ◽  
Bony Metastases

Gastric cancer is the 12th leading cause of cancer-related deaths in the United States and commonly metastasizes to the bones. However, the presentation of gastric cancer as bony metastases without preceding gastrointestinal symptoms is rare which has been infrequently reported in the literature. Moreover, leptomeningeal carcinomatosis is an unusual complication of gastric cancer accounting for less than 1 percent of these patients. We present a unique case of a middle aged male who presented to the emergency department with worsening backache which started one month priorly. The only abnormal laboratory test was an elevated alkaline phosphatase of 154 IU/L. The imaging of his spine showed osteolytic lesions which on biopsy revealed signet ring cells. A small 2 cm ulcerated mass was found on esophagogastroduodenoscopy at the gastric cardia which on biopsy revealed signet ring gastric carcinoma. The patient received chemotherapy with capecitabine and oxaliplatin as well as radiation and showed a good response initially. A few months later, he presented with persistent worsening headaches and on brain imaging was found to have leptomeningeal carcinomatosis. Ten months after the diagnosis of gastric carcinoma, he passed away.

scholarly journals Wernicke Encephalopathy Due to Prolonged Total Parenteral Nutrition in A Child with Signet Ring Cell Gastric Carcinoma

2020 ◽  
pp. 30-33
Author(s):  
Buket KARA ◽  
Ayse KARTAL ◽  
Mehmet ÖZTÜRK ◽  
Yavuz KÖKSAL
Keyword(s):  
Gastric Cancer ◽  
Gastric Carcinoma ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Signet Ring Cell ◽  
Diffuse Gastric Cancer ◽  
Wernicke Encephalopathy ◽  
Signet Ring ◽  
Ring Cell

Signet ring cell gastric carcinoma is extremely rare during childhood. One of the most important problems in these patients is nutritional difficulty and impairment, and these patients are often supported by total parenteral nutrition. Herein, the authors report a case of Wernicke encephalopathy due to prolonged total parenteral nutrition in a 13-year-old girl with diffuse gastric cancer with signet ring cell.

scholarly journals Gastric Cancer Presenting as Isolated Ascites: A Diagnostic Challenge

2019 ◽  
Author(s):  
Ines Duarte ◽  
Cristina Outerelo
Keyword(s):  
Gastric Cancer ◽  
Abdominal Pain ◽  
Gastric Carcinoma ◽  
Male Patient ◽  
Gastrointestinal Symptoms ◽  
Malignant Ascites ◽  
Rapid Onset ◽  
Clinical State ◽  
Diagnostic Challenge ◽  
Gastric Endoscopy

Malignant ascites is a rare first manifestation of gastric carcinoma and is usually associated with symptoms which include early satiety, abdominal pain and deteriorating clinical state. The authors describe the case of a male patient presenting with malignant ascites of rapid onset which was the sole presentation of gastric cancer, highlighting the importance of upper gastric endoscopy even in the absence of gastrointestinal symptoms.

scholarly journals Prognostic Significance of Signet Ring Gastric Cancer

2012 ◽  
Vol 30 (28) ◽  
pp. 3493-3498 ◽  
Author(s):  
Sharven Taghavi ◽  
Senthil N. Jayarajan ◽  
Adam Davey ◽  
Alliric I. Willis
Keyword(s):  
United States ◽  
Gastric Cancer ◽  
Alaska Native ◽  
Prognostic Significance ◽  
Distant Metastases ◽  
Tumor Grade ◽  
The United States ◽  
Signet Ring Cell ◽  
Signet Ring ◽  
Worse Prognosis

Purpose Studies in Asia have questioned the dictum that signet ring cell carcinoma (SRC) has a worse prognosis than other forms of gastric cancer. Our study determined differences in presentation and outcomes between SRC and gastric adenocarcinoma (AC) in the United States. Patients and Methods The National Cancer Institute Surveillance, Epidemiology, and End Results database was reviewed for SRC and AC from 2004 to 2007. Results We reviewed 10,246 cases of patients with gastric cancer, including 2,666 of SRC and 7,580 of AC. SRC presented in younger patients (61.9 v 68.7 years; P < .001) and less often in men (52.7% v 68.7%; P < .001). SRC patients were more frequently black (11.3% v 10.9%), Asian (16.4% v 13.2%), American Indian/Alaska Native (0.9% v 0.8%), or Hispanic (23.3% v 14.0%; P < .001). SRC was more likely to be stage T3-4 (45.8% v 33.3%), have lymph node spread (59.7% v 51.8%), and distant metastases (40.2% v 37.6%; P < .001). SRC was more likely to be found in the lower (30.7% v 24.2%) and middle stomach (30.6% v 20.7%; P < .001). Median survival was not different between the two (AC, 14.0 months v SRC, 13.0 months; P = .073). Multivariable analyses demonstrated SRC was not associated with mortality (hazard ratio [HR], 1.05; 95% CI, 0.96 to 1.11; P = .150). Mortality was associated with age (HR, 1.01; 95% CI, 1.01 to 1.02; P < .001), black race (HR, 1.10; 95% CI, 1.01 to 1.20; P = .026), and tumor grade. Variables associated with lower mortality risk included Asian race (HR, 0.83; 95% CI, 0.77 to 0.91; P < .001) and surgery (HR, 0.37; 95% CI, 0.34 to 0.39; P < .001). Conclusion In the United States, SRC significantly differs from AC in extent of disease at presentation. However, when adjusted for stage, SRC does not portend a worse prognosis.

Patterns of gastric cancer metastasis within the United States.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 329-329
Author(s):  
Joseph Sirody ◽  
Amy H. Kaji ◽  
Danielle M. Hari ◽  
Kathryn Tzung-Kai Chen
Keyword(s):  
United States ◽  
Gastric Cancer ◽  
Overall Survival ◽  
Liver Metastases ◽  
Cancer Metastasis ◽  
The United States ◽  
Peritoneal Metastases ◽  
Peritoneal Disease ◽  
Metastatic Site ◽  
Signet Ring

329 Background: There are few reports on the epidemiology of gastric cancer metastasis, although outcomes are known to be uniformly poor. Here we describe the patterns of gastric cancer metastasis and treatment in the United States (US). Methods: Patients with gastric adenocarcinoma histologies were identified in the National Cancer Database (NCDB) from 2004-2016. We describe univariate associations between different sites of metastasis and clinicopathologic characteristics and treatment modalities, using the chi-square and Kruskal-Wallis tests. Kaplan Meier curves were constructed for the estimation of overall survival (OS) by metastatic site. Results: Due to changes in the coding of metastatic disease, we were limited to the year 2016 for evaluation of patterns of disease. Twenty-six percent (n = 1228) of gastric cancer patients presented with liver metastases, 20% (n = 941) with distant nodes, 43% (n = 2028) with other distant site metastases (including peritoneum), and the rest to bone, brain or lung. On univariate analysis, when compared to liver metastases, other distant site metastases were significantly more likely to arise from an antral primary site (28% v. 16%); to be of Hispanic origin (16% v. 7%); female (42% v. 29%); associated with signet ring histology (34% v. 6%); lymphovascular invasion (LVI) (58% v. 27%); and tumor grade III/IV (85% vs. 60%) (p < 0.0001 for all). There were no significant differences in how patients with metastatic disease were treated in terms of systemic therapy. With regard to OS, due to how metastatic sites were coded prior to 2016, it was not possible to compare peritoneal metastases against other sites; however, patients with distant nodal disease had improved median overall survival compared to those with any other metastatic site (7.9 v. 5.2 months, p < 0.0001). Conclusions: The majority of US patients with metastatic gastric cancer present with presumed peritoneal disease. Predictive factors for peritoneal metastases vs. liver metastases included adverse prognostic features, including signet ring histology, higher tumor grades, and LVI. Although it was not possible to compare OS of peritoneal disease against other sites, continued follow up is needed, as this may impact future staging.

scholarly journals Breast Metastasis of Gastric Signet Ring Cell Carcinoma: A Case Report and Literature Review

2021 ◽  
pp. 165-172
Author(s):  
Héctor Hugo Buerba-Vieregge ◽  
Ricardo Fernández-Ferreira ◽  
Pamela Denisse Soberanis-Piña ◽  
Ildefonso Roberto De la Peña-López ◽  
Lilian Mónica Navarro-García ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Carcinoma ◽  
Cell Carcinoma ◽  
Clinical History ◽  
Complete Response ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Breast Metastasis ◽  
Signet Ring ◽  
Ring Cell

Breast metastasis from gastric signet ring cell carcinoma is extremely rare in clinical practice. The estimated incidence is 0.5–1.3%. There are few cases reported in the literature (approx. less than 60) of breast metastasis from gastric signet ring cell carcinoma, and due to the rare association between gastric cancer and its extension to the breast, it is difficult to establish the diagnosis. Clinical history, histological findings, and immunohistochemical markers are helpful in distinguishing primary breast cancer from breast metastasis of gastric cancer. The treatment for breast metastasis from gastric carcinoma remains controversial. The prognosis of breast metastasis from gastric carcinoma is generally poor. We report a case of breast metastasis of gastric signet ring cell carcinoma in a 38-year-old woman. She started chemotherapy with ramucirumab, paclitaxel, and irinotecan. Three months later, a combined 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography showed a complete response. This is the first reported case of breast metastasis from gastric signet ring cell carcinoma with a complete response.

Differential Trends in the Intestinal and Diffuse Types of Gastric Carcinoma in the United States, 1973–2000: Increase in the Signet Ring Cell Type

2004 ◽  
Vol 128 (7) ◽  
pp. 765-770 ◽  
Author(s):  
Donald Earl Henson ◽  
Christopher Dittus ◽  
Mamoun Younes ◽  
Hong Nguyen ◽  
Jorge Albores-Saavedra
Keyword(s):  
Gastric Cancer ◽  
African Americans ◽  
Gastric Carcinoma ◽  
Signet Ring Cell ◽  
Intestinal Type ◽  
Diffuse Type ◽  
Cell Type ◽  
Gastric Carcinomas ◽  
Signet Ring ◽  
Ring Cell

Abstract Context.—During the last 50 years, the incidence and mortality of gastric cancer has declined in many countries. This decline has primarily included the intestinal type (Lauren classification). However, there is an impression among pathologists that the diffuse type, especially the signet ring cell subtype, has become more prevalent. Objectives.—Using data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, we analyzed the trends of the 2 primary types (intestinal and diffuse) of gastric carcinomas from 1973 through 2000. Design.—Trends in age-adjusted rates were determined for gastric carcinomas through the SEER statistical program (SEER*Stat), which is available on the Internet to the public. Results.—During the period studied, the intestinal type continued to decline in males, females, African Americans, and whites. The intestinal type was more common in males than in females and more common in African Americans than in whites. In contrast, a consistent increase in the rate of the diffuse type of gastric carcinoma was seen during this period. The rate increased from 0.3 cases per 100 000 persons in 1973 to 1.8 cases per 100 000 persons in 2000. This increase was seen in males, females, African Americans, and whites. The predominant increase occurred in the signet ring type. Conclusions.—The results indicate a progressive decrease in the incidence of the intestinal type of gastric cancer and an increase in the diffuse type of gastric carcinoma, especially the signet ring cell type. The clinical implications of the increase are considered.

Survival outcomes based on race in gastric carcinoma: A SEER database analysis.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 5-5
Author(s):  
N. Didwaniya ◽  
R. J. Edmonds ◽  
P. T. Silberstein ◽  
S. Subbiah
Keyword(s):  
Gastric Cancer ◽  
Gastric Carcinoma ◽  
Survival Rates ◽  
Tumor Grade ◽  
The United States ◽  
Lymph Node Involvement ◽  
Tnm Staging ◽  
Treatment Modalities ◽  
Seer Database ◽  
Cancer Specific Survival

5 Background: Gastric cancer is one of the leading causes of cancer related deaths worldwide with the incidence declining in the United States. However the prognosis remains poor with variable survivals being reported among different races. We analyzed the effect of race on patterns of disease presentation and survival rates using the Surveillance, Epidemiology, and End Results (SEER) database. Methods: A total of 9,851 patients were diagnosed with gastric cancer from year 2004 to 2007 were identified from SEER database. Age, race, TNM staging, grade, treatment modalities utilized and cancer specific survival was collected. Results: Out of 9,851 patients, 64.63% were white, 12.17% were black, and 13.04% were Asian-Pacific islanders. Median age was 73 years for whites, 70 years in blacks, and 71 years in Asians. Sex distribution amongst races was more or less similar with 58.83% of whites, 59.47% of blacks, and 54.24% of Asians being men. 23.62% of whites had T1 lesions, 28.10% had T2, 19.58% were T3 and 28.70% had T4 lesions. 26.76% of blacks presented with T1 lesions, 26.63% with T2, 16.08% with T3 and 30.53% with T4. 18.69% of Asians had T1 lesions, 26.84% with T2, 23.44% had T3 and 31.03% had T4 lesions. 37.80% of whites, 36.70% of blacks, and 44.44% of Asians had lymph node involvement. Tumor grade was similar among all races. Surgery was performed in 31.49% of whites, 33.13% of blacks, and 40.48% of Asians. 14.68% of whites, 14.10% of blacks, and 19.43 % of all Asians underwent radiation therapy. Median overall survival in localized disease was 44 months, 43 months and 98 months (p < 0.0001) while in regional disease it was 16 months, 15 months and 23 months in whites, blacks and Asians respectively (p < 0.0001). Median survival in distant disease was 4 months in both whites and blacks; it was 5 months in Asians (p < 0.0001). Conclusions: Cancer-specific survival in gastric carcinoma is significantly better in localized, regional and metastatic disease in Asians when compared to whites and blacks independent of T stage, grade, nodal involvement and treatment modalities utilized. The reason for this observation is unclear, exposure and genetic factors are potential causes and this needs to be investigated. No significant financial relationships to disclose.

Signet ring cell gastric carcinoma: A descriptive analysis of a unique county population.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 32-32
Author(s):  
Mital Patel ◽  
Neha Patel ◽  
James H. Tabibian ◽  
Nora Ostrzega
Keyword(s):  
Gastric Carcinoma ◽  
Patient Population ◽  
Serum Antibody ◽  
The United States ◽  
Signet Ring Cell ◽  
Minority Population ◽  
Signet Ring ◽  
Predominantly Minority ◽  
Seer Data ◽  
Ring Cell

32 Background: Signet ring cell type gastric carcinoma (SRCC) is an uncommon epithelial malignancy of the stomach, with data from the United States (US) being particularly scarce. Compared to other gastric carcinoma types, it has a female predominance, younger age at diagnosis, and late presentation, making treatment particularly challenging. Recent reports suggest this disease may be increasing among even younger patients, for reasons which remain unclear. We aimed to examine the occurrence, features, and outcomes of SRCC in a predominantly minority Los Angeles County patient population. Methods: We identified all patients diagnosed with SRCC at Olive View-UCLA Medical Center (OVMC) from 2004-2017. Clinico-demographic, imaging, and pathologic data were reviewed and analyzed and compared descriptively to available Surveillance, Epidemiology, and End Results (SEER) data. Results: Sixty-six cases of SRCC were identified, of which 77% were Latino, 9% White, 6% Armenian, and the remaining 8% other. Mean age at SRCC diagnosis was 52 years, and 37 (56%) of patients were female. H. pylori infection was present in 35% (43% diagnosed by serum antibody, 35% by pathology, 9% by stool antigen, and 13% by combination). Follow-up was available for 91% of patients. Median survival was 1 year, and 5-year survival was 7%, markedly lower than the 31% reported in SEER. Seventy-two percent of patients were deceased or on hospice within 2 years of diagnosis. Conclusions: In this first US study to assess the clinical epidemiology of SRCC in a predominantly minority population: 1) the mean age of diagnosis was younger than reported in previous studies (55-61 years), 2) the proportion of males was high compared to SEER data, and 3) survival was considerably lower than previously reported. Insofar as the patient population in this study serves as a microcosm of surrounding underserved communities, it is likely that SRCC may be more common than expected in this vulnerable patient population, and that significant clinical differences may exist in presentation and outcomes of SRCC. In light of these differences, further research is needed to examine potential environmental and/or genetic risk factors or disparities which may be operational.

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