60-Year-Old Woman Successfully Treated for Gastric Signet Ring Cell Carcinoma with Minimally Invasive Surgery

A 60-year-old female patient with a long history of Helicobacter pylori infection was admitted to our hospital due to persistent abdominal pain that did not improve with over-the-counter medication. After a series of diagnostic tests, she was diagnosed with gastric signet ring cell carcinoma. Following a minimally invasive endoscopic mucosal resection, the patient experienced a full recovery with no signs of tumor recurrence or metastasis during follow-up visits. The treatment was conducted at Sun Yat-sen University Cancer Center in January 2022 and involved a short hospital stay of three days, followed by regular check-ups.

Early Symptoms and Initial Diagnosis

The patient, a 60-year-old woman named Ms. Zheng, had been living with Helicobacter pylori infection for over two decades. Around two months prior to her hospital visit, she began experiencing mild abdominal pain and a reduced appetite. Initially, she attributed these symptoms to indigestion and tried self-medicating with digestive aids, but her condition did not improve. Upon clinical evaluation, stool tests revealed occult blood, and a carbon-13 urea breath test confirmed the presence of H. pylori. A subsequent gastroscopy identified a 1.2×1.5 cm irregular lesion in the stomach lining. Biopsy results confirmed diffuse infiltration of signet ring cell carcinoma without distinct tumor nests, leading to a clear diagnosis of gastric signet ring cell cancer.

Minimally Invasive Treatment Approach

To assess the extent of the disease, a PET-CT scan was performed, which showed no evidence of distant metastasis. Given the patient's reluctance toward traditional surgery, the medical team proposed endoscopic mucosal resection—a minimally invasive procedure with minimal trauma and a faster recovery time. After thorough preoperative evaluations, including blood tests, biochemical profiles, and electrocardiogram readings, the patient was deemed a suitable candidate for the procedure. The surgery was successfully performed, and postoperative pathology confirmed complete tumor removal with clean margins and no submucosal invasion. As a result, no additional therapy was required.

Positive Recovery and Follow-Up Results

The patient's recovery was smooth and uneventful. By the third day of hospitalization, her vital signs were stable, and her appetite had significantly improved. She was discharged with no postoperative complications. During follow-up appointments, all test results remained normal, and there were no indications of cancer recurrence or metastasis. Her symptoms had completely resolved, and her overall health status was excellent.

Postoperative Care and Lifestyle Recommendations

To support long-term recovery and prevent recurrence, the patient was advised to make several lifestyle adjustments. She was encouraged to avoid high-sugar and high-fat foods that could increase gastric acid production and cause discomfort. Beverages such as tea and coffee were also discouraged due to their potential to stimulate gastric secretions. Additionally, moderate physical activity like walking or light exercise was recommended to promote digestion and overall well-being.

Insights on Gastric Signet Ring Cell Carcinoma

While the exact causes of gastric signet ring cell carcinoma are still being studied, risk factors such as diet, environmental exposure, genetics, and chronic H. pylori infection are believed to play a role. In this case, the patient's long-standing H. pylori infection likely contributed to the development of cancer. Fortunately, early detection allowed for effective treatment with endoscopic resection. This case highlights the importance of timely medical intervention for H. pylori infection to prevent potentially life-threatening complications like gastric cancer.