Disappearing signet ring cell adenocarcinoma in gastric cancer patients Journal Article
| Authors: | Sreeram, A.; Stroobant, E. E.; Laszkowska, M.; Guilford, P.; Shimada, S.; Nishimura, M.; Shah, S.; Vardhana, S.; Tang, L. H.; Strong, V. E. |
| Article Title: | Disappearing signet ring cell adenocarcinoma in gastric cancer patients |
| Abstract: | Background: The incidence of diffuse-type gastric cancer is increasing steadily in the United States, Europe, and Asia. This subtype is known for aggressive clinical characteristics and transmural invasion. However, T1a diffuse-type cancers have been observed to have a better 5-year, disease-specific mortality than stage-matched intestinal tumors, supporting a clinical difference in these early-stage cancers. Methods: Data on all living patients with T1a gastric adenocarcinoma with a finding of signet ring cell morphology on pathology and ≥1 year of follow-up from 2013 to 2023 at Memorial Sloan Kettering Cancer Center (MSK) was collected from a prospectively maintained database. Patients with known CDH1 or CTNNA1 mutations were excluded. Results: In 7 of 30 patients, sporadic pathologically confirmed T1a signet ring cell (diffuse) cancer identified on initial biopsy was no longer detectable upon subsequent biopsy or resection with mean follow-up of 50 months. Conclusions: These cases allude to the distinct pathways of carcinogenesis in T1a signet ring cell cancers. Potential factors that may underlie the spontaneous regression of these T1a cancers include complete removal at initial biopsy, immune clearance, and lack of survival advantage conferred by signet ring cell genetic alterations in these cases. Given their more indolent behavior at an earlier stage, we suggest that these lesions can be closely followed by endoscopy in select circumstances with thorough disease assessment and an experienced care team. © Society of Surgical Oncology 2024. |
| Keywords: | adult; clinical article; human tissue; aged; aged, 80 and over; middle aged; survival rate; human cell; genetics; mutation; fatigue; histopathology; case report; follow up; follow-up studies; cancer diagnosis; prospective study; prospective studies; adenocarcinoma; pathology; renal cell carcinoma; carcinogenesis; abdominal pain; proton pump inhibitor; stomach ulcer; erythema; nausea and vomiting; gastrectomy; stomach cancer; hemorrhagic gastritis; disease predisposition; stomach adenocarcinoma; genetic screening; endoscopy; stomach neoplasms; signet ring carcinoma; carcinoma, signet ring cell; stomach tumor; epigastric pain; gastric cancer; partial gastrectomy; gastric adenocarcinoma; recurrence free survival; hematochezia; bloating; esophagogastroduodenoscopy; gastritis; eradication therapy; helicobacter infection; germline mutation; total gastrectomy; signet ring cell carcinoma; intestinal metaplasia; malt lymphoma; early gastric cancer; very elderly; humans; prognosis; human; male; female; article; ductal breast carcinoma in situ; diffuse-type gastric carcinoma; greater curvature of the stomach; mucosa associated lymphoid tissue; right upper abdominal quadrant; sessile polyp |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 31 |
| Issue: | 13 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2024-12-01 |
| Start Page: | 9030 |
| End Page: | 9038 |
| Language: | English |
| DOI: | 10.1245/s10434-024-16117-8 |
| PUBMED: | 39343820 |
| PROVIDER: | scopus |
| PMCID: | PMC11694483 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Vivian Strong -- Source: Scopus |
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