Раковая наука и терапия

Complete Pathologic Response in Advanced Primary Gastric Signet-Ring Cell Carcinoma: A Case Report

Abstract

Yousra Akasbi, Samia Arifi, Abdelmalek Ousadden, Siham Tizniti, Afaf Amarti, Khalid Ait Taleb and Omar EL Mesbahi

Background: Gastric signet ring cell carcinoma (SRC) is a poorly differentiated adenocarcinoma in which the tumour cells invade singly or in small groups. The incidence of SRC has been reported in china as 13.9% (662 patients of 4,759) [1]. It is reported to occur more frequent among women and young patients. A regimen of epirubicin, cisplatin, and infused fluorouracil (ECF) improves survival among patients with incurable locally advanced or metastatic gastric adenocarcinoma. Case presentation: A 38-year-old female presented with a 3 weeks history of epigastralgia. Her medical history was unremarkable. The endoscopic findings of the stomach revealed an infiltrative lesion, which the guided biopsy yielded a positive pathologic diagnosis of signet ring cell carcinoma. Diagnostic imaging with an abdominal computed tomography (CT) scan revealed a gastric thickening, with lymph nodes. Induction chemotherapy was recommended, based on 6 cycles of ECX (Epirubicin 50 mg/m2, Cisplatin 60 mg/m2, Capecitabine 625 mg/m2). The total gastrectomy specimen showed a pathological complete response. The patient, who is always followed in consultation, is in complete remission 19 months after the diagnosis Conclusion: SRC is a distinctive histological type of gastric cancer. The ECX or EOX (epirubicin, oxaliplatine, capecitabine) remains the standard treatment of advanced primary gastric signet-ring cell carcinoma. Our case illustrates a complete pathologic response to ECX, which confirmed the effectiveness of this protocol on this histology.