Synchronous Gastric Signet-Ring Cell Adenocarcinoma and Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma Treated With Robotic Total Gastrectomy: A Case Report and Literature Review
Abstract
The synchronous occurrence of gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma is rare, and coexistence with signet-ring cell adenocarcinoma is particularly uncommon. We report a 43-year-old White Brazilian man with a history of gastroesophageal reflux disease, nondysplastic Barrett's esophagus, and previous laparoscopic Nissen fundoplication. During endoscopic follow-up, chronic gastritis, persistent Helicobacter pylori (H. pylori) infection, and gastric MALT lymphoma were identified. Despite eradication therapy, H. pylori and the lymphomatous infiltrate persisted, and a 15-mm depressed antral lesion became evident. Serial biopsies and immunohistochemistry demonstrated synchronous signet-ring cell adenocarcinoma and MALT lymphoma. Endoscopic ultrasonography suggested focal superficial submucosal involvement, whereas computed tomography and positron emission tomography-computed tomography showed no metastatic disease. Following multidisciplinary review, the patient underwent robotic total gastrectomy with D2 lymphadenectomy and Roux-en-Y reconstruction using the da Vinci X platform. The postoperative course was uneventful, and discharge occurred on postoperative day 7. Surgical pathology revealed a 1.2-cm poorly differentiated signet-ring cell adenocarcinoma confined to the muscularis mucosae, residual MALT lymphoma, persistent H. pylori, and no metastatic tumor in 19 lymph nodes (pT1aN0M0). This case emphasizes the need for systematic endoscopic…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Ferulic acid regulates the AKT/GSK-3β/CRMP-2 signaling pathway in a middle cerebral artery occlusion animal model
- Novel Pharmacokinetic/Pharmacodynamic Parameters Quantify the Exposure–Effect Relationship of Levofloxacin against Fluoroquinolone-Resistant Escherichia coli
- Photochemical behavior of levofloxacin
- Correlation Between Dissolution Profiles of Salt-Form Drugs in Biorelevant Bicarbonate Buffer and Oral Drug Absorption: Importance of Dose/ Fluid Volume Ratio
- Evaluation of the synergistic potential and mechanisms of action for de novo designed cationic antimicrobial peptides
- Synthesis of [11C]levofloxacin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.