Gastric signet-ring cell carcinoma (SRCC) is a rare, highly malignant epithelial adenocarcinoma. Its incidence is increasing constantly in the developed world. SRCC is more frequent in women, with the mean age ranging from 55 to 61 years. This case aims to provide multidisciplinary insight in diagnosing SRCC and challenging diagnostic road to the final diagnosis.
Case report: A 32-year-old male was hospitalized in a regional hospital with progressing back pain for which he used Dexketoprofen for 2 months. Accompanying symptoms were weight loss, progressive fatigue, subfebrile body temperature and night sweats. X-rays of chest and skull as well as abdominal CT scan revealed lytic process as in multiple myeloma or bone marrow lesions. Patient was transferred to Riga Eastern University Hospital for diagnosis of myeloma, although with signs of bleeding from the upper gastrointestinal tract patient underwent emergency esophagogastroduodenoscopy. Several ulcerations were found and biopsied. Patient was admitted to the department of gastroenterology. No paraproteins were found in plasma or urine. Hematologist was consulted and a trephine biopsy was done. Repeated review of the abdominal CT scan revealed slight thickening of the antrum of the stomach. Biopsy results confirmed anaplastic gastric SRCC and similar findings in bone marrow biopsy. The patient never smoked and had no oncopathology in family history.Keywords: Gastric cancer, Signet ring cell carcinoma, “red flags” of back pain. Gastric SRCC with diffuse lytic dissemination in bone marrow was confirmed. During the hospitalization severe back pain progressed constraining the mobility index to ECOG 3. For this reason oncological consilium indicated palliative treatment as the patient's condition was too severe for chemotherapy. 1. This case shows the importance of multidisciplinary approach.
2. Back pain in young adults may conceal a diagnosis of cancer.
3. “Red flags” symptoms should never be ignored.
- 3.4. Other publications in conference proceedings (including local)