title: Primary gastric signet ring cell carcinoma presenting as cardiac tamponade.
abstract: Primary gastric signet ring cell carcinoma presenting as cardiac tamponade is difficult to diagnosis early. Patients are generally asymptomatic until the disease is advanced. General practitioners usually focus on the initial symptoms related to pericarditis and pericardial effusion. We report a case of signet-ring cell carcinoma of the stomach presenting as cardiac tamponade with pericarditis and pericardial effusion but without any gastrointestinal symptoms. A 49-year old woman was admitted because of progressive dyspnea and cough. Chest X-ray revealed an increased cardiothoracic ratio and a small amount of bilateral pleural effusion. Two dimensional ultrasonographic echocardiography pericardial effusions with atrial and right ventricular early diastolic collapse were found, establishing the diagnosis of cardiac tamponade. Pericardiocentesis was performed and 420 mL of bloody ﬂuid was taken. The patient died of respiratory failure and cardiac arrest on October 28, 2009. Post-mortem examination revealed diffuse gastric mucosa erosion and edema with stomach mucosa incrassation in the greater curvature. The primary lesion was histopathologically diagnosed as signet-ring cell carcinoma of the stomach.
authors.affiliation: Jun-Yan Huang, Hai-Ping Jiang, Han-Lin Tang, Department of General Surgery, The First Affiliated Hospital of Jinan University, West No. 613, Huangpu Road, Guangzhou 510630, Guangdong Province, China.
authors.forename: Jun-Yan
authors.initials: JY
authors.lastname: Huang
authors.forename: Hai-Ping
authors.initials: HP
authors.lastname: Jiang
authors.forename: Dan
authors.initials: D
authors.lastname: Chen
authors.forename: Han-Lin
authors.initials: HL
authors.lastname: Tang