Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2018; 24(26): 2915-2920
Published online Jul 14, 2018. doi: 10.3748/wjg.v24.i26.2915
Gastric adenocarcinoma of fundic gland type with signet-ring cell carcinoma component: A case report and review of the literature
Keita Kai, Masaaki Satake, Osamu Tokunaga
Keita Kai, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan
Masaaki Satake, Department of Gastroenterology, Koga Hospital 21, Kurume 839-0801, Japan
Osamu Tokunaga, Department of Pathology, Shin Koga Hospital, Kurume 830-8577, Japan
Author contributions: Kai K is the main author of this article; Satake M was attending doctor and performed endoscopic submucosal dissection; Kai K and Tokunaga O performed pathological diagnosis; Tokunaga O and Satake M reviewed the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Keita Kai, MD, PhD, Associate Professor, Department of Pathology, Saga University Hospital, Nabeshima 5-1-1, Saga City, Saga 849-8501, Japan.
Telephone: +81-952-343264 Fax: +81-952-342055
Received: April 13, 2018
Peer-review started: April 13, 2018
First decision: May 21, 2018
Revised: May 22, 2018
Accepted: June 9, 2018
Article in press: June 9, 2018
Published online: July 14, 2018
Case characteristics

A 76-year-old Japanese woman visited a nearby clinic complaining of a dull feeling in the stomach.

Clinical diagnosis

Esophagogastroduodenoscopy (EGD) revealed a depressed lesion at a gastric angle of the greater curvature side.

Differential diagnosis

The clinical diagnosis of early gastric cancer was considered by EGD findings.

Laboratory diagnosis

No specific finding was obtained by laboratory testing.

Imaging diagnosis

The narrow band imaging of EGD showed a relatively demarcated lesion with an irregular microsurface pattern.

Pathological diagnosis

Pathological findings of endoscopic submucosal dissection (ESD) specimens indicated the diagnosis of gastric adenocarcinoma of fundic gland type (GA-FG) with a signet-ring cell carcinoma component.


Only ESD was performed for treatment.

Related reports

To the best of our knowledge, no GA-FG case with a poorly differentiated adenocarcinoma or signet-ring cell carcinoma component has been reported.

Term explanation

The term GA-FG describes gastric adenocarcinoma of fundic gland type.

Experiences and lessons

This is the first case report of GA-FG with a signet-ring cell carcinoma component.