Case History: 62-year-old male with history of abdominal pain and weight loss for two months.
Case History: 62-year-old male presents with history of abdominal pain and weight loss for two months.
Figure 3. MRI: Dual echo images showing drop of signal in opposed phase in MRI representing intracellular fat consistent with benign adenoma (arrows).
Figure 4. Linitis plastica of the stomach, which typically has a signet ring cell pattern of adenocarcinoma diffusely infiltrating the stomach.
Endoscopic ultrasound revealed the involvement of all three layers of the gastric body with breached muscularis propria.
CT also demonstrated an indeterminate right adrenal nodule showing progressive enhancement in the arterial and venous phase.
Metastatic disease was excluded and the patient underwent an uneventful total gastrectomy followed by adjuvant chemotherapy.
Signet ring cell adenocarcinoma of the stomach is characterized by diffuse infiltration of signet ring type of tumor cells into the gastric wall.
The main carcinogenic event in diffuse type cancers is loss of expression of E-cadherin, a key cell surface protein for establishing intercellular connections.
Hereditary diffuse gastric cancer are autosomal dominant, have very high penetrance with a lifetime cumulative risk of 40%-67% in men and 60%-83% in women.
Chest X-ray can be used to assess for metastases, though CT is preferred, especially for proximal cancers.
The treatment of linitis plastica is indefinite as authors are divided with regards to treatment plans.