Clin Endosc.  2012 Nov;45(4):421-424.

Signet-Ring Cell Carcinoma Mimicking Gastric Gastrointestinal Stromal Tumor Confirmed by Endoscopic Ultrasound-Guided Trucut Biopsy

• Kim SH
• Lee ST
• Jeon BJ
• Kim IH
• Kim SW
• Lee SO
• Kim DG
• Park HS

Abstract

A submucosal gastric adenocarcinoma, especially the signet ring cell type, is rare. The histologic evaluation techniques for this lesion has not been established; however, histologic confirmation is very important for decision of treatment method. Here, we report a 57-year-old man with a 12-cm gastric submucosal signet ring cell type adenocarcinoma, diagnosed by an endoscopic ultrasound-guided Trucut biopsy and immunochemical studies. This case suggests that the endoscopic ultrasound-guided Trucut biopsy might be a useful diagnostic method in cases of gastric adenocarcinoma with features of gastrointestinal stromal tumor.

Keyword

Stomach neoplasms; Signet ring cell; Gastrointestinal stromal tumors; Endosonography; Biopsy

MeSH Terms

Adenocarcinoma
Biopsy
Endosonography
Gastrointestinal Stromal Tumors
Humans
Middle Aged
Stomach Neoplasms

Reference

1. Wiersema MJ, Wiersema LM, Khusro Q, Cramer HM, Tao LC. Combined endosonography and fine-needle aspiration cytology in the evaluation of gastrointestinal lesions. Gastrointest Endosc. 1994; 40(2 Pt 1):199–206. PMID: 8013822.

2. Kume K, Yoshikawa I, Yamazaki M, Abe S, Murata I, Otsuki M. A case of gastric cancer with features of submucosal tumor. Gastrointest Endosc. 2001; 53:247–249. PMID: 11174309.

3. Gu M, Ghafari S, Nguyen PT, Lin F. Cytologic diagnosis of gastrointestinal stromal tumors of the stomach by endoscopic ultrasound-guided fine-needle aspiration biopsy: cytomorphologic and immunohistochemical study of 12 cases. Diagn Cytopathol. 2001; 25:343–350. PMID: 11747229.

4. Kim SY, Park JJ, Cho Y, et al. A case of submucosal tumor-like early gastric adenocarcinoma diagnosed by endoscopic mucosal resection. Korean J Gastrointest Endosc. 2005; 31:404–408.

5. Takahashi T, Otani Y, Yoshida M, et al. Gastric cancer mimicking a submucosal tumor diagnosed by laparoscopic excision biopsy. J Laparoendosc Adv Surg Tech A. 2005; 15:51–56. PMID: 15772477.

6. Matsushita M, Shiroeda O, Inokuchi H, et al. A case of early gastric cancer manifesting as a submucosal tumor. Dig Endosc. 1994; 6:269–274.

7. Takemoto N, Baba Y, Kaku Y, et al. Radiologic diagnosis of gastric cancer morphologically mimicking submucosal tumor. Stomach Intest. 1995; 30:759–768.

8. Nakamura T, Suzuki T, Kobayashi S, et al. Diagnosis of gastric carcinoma with the appearance of a submucosal tumor of the stomach, using endoscopic ultrasonography. Stomach Intest. 1995; 30:787–798.

9. Lee JH, Shin JE, Kim BH, et al. A case of early gastric adenocarcinoma mimiking a submucosal tumor. Korean J Gastrointest Endosc. 2007; 35:250–253.

10. Yasuda K, Nakajima M, Yoshida S, Kiyota K, Kawai K. The diagnosis of submucosal tumors of the stomach by endoscopic ultrasonography. Gastrointest Endosc. 1989; 35:10–15. PMID: 2646166.

11. Mekky MA, Yamao K, Sawaki A, et al. Diagnostic utility of EUS-guided FNA in patients with gastric submucosal tumors. Gastrointest Endosc. 2010; 71:913–919. PMID: 20226456.

12. Săftoiu A, Vilmann P, Guldhammer Skov B, Georgescu CV. Endoscopic ultrasound (EUS)-guided Trucut biopsy adds significant information to EUS-guided fine-needle aspiration in selected patients: a prospective study. Scand J Gastroenterol. 2007; 42:117–125. PMID: 17190771.

13. Cantor MJ, Davila RE, Faigel DO. Yield of tissue sampling for subepithelial lesions evaluated by EUS: a comparison between forceps biopsies and endoscopic submucosal resection. Gastrointest Endosc. 2006; 64:29–34. PMID: 16813799.