title: Intracranial hypertension as the primary symptom of gastric signet-ring cell carcinoma: A case report and literature review.
abstract: BACKGROUND
  Intracranial hypertension (IH) is a neurological disorder characterized by increased intracranial pressure. It is a poorly understood syndrome that most commonly manifests nonspecific symptoms such as stroke-like headache, vision changes, nausea, vomiting, and papilledema. IH has been reported in young cancer patients but never in association with gastric signet-ring cell carcinoma.
  
  
  METHODS
  Here, we discuss the case of an 18-year-old girl with gastric signet-ring cell carcinoma in which IH was the primary symptom accompanied by the even rarer symptom of cutaneous metastases. We also present a review of the relevant literature. The patient experienced frequent headaches, vomiting, and blurred vision but showed no abnormal findings on cranial imaging studies. Further examination showed multiple skin nodules on the abdomen. Then pathological and immunohistochemical examination of gastroscopic specimens and the biopsied subcutaneous nodules were done.
  
  
  RESULTS
  Pathological and immunohistochemical examination of gastroscopic specimens and the biopsied subcutaneous nodules confirmed gastric signet-ring cell carcinoma with skin metastases.
  
  
  CONCLUSIONS
  To our knowledge, this is the first reported case of gastric signet-ring cell carcinoma primarily presenting IH and accompanied by subcutaneous metastases. This case emphasizes the importance of excluding malignancy from the differential diagnosis of IH.
authors: Department of Neurology, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
authors: Jiali
authors: J
authors: Pu
authors: Lingjia
authors: L
authors: Xu
authors: Xinzhen
authors: X
authors: Yin
authors: Baorong
authors: B
authors: Zhang
mesh_terms: D000293:Adolescent; D001706:Biopsy; D018279:Carcinoma, Signet Ring Cell / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D005773:Gastroscopy; D006801:Humans; D007150:Immunohistochemistry; D019586:Intracranial Hypertension / Q000209:etiology*; D011379:Prognosis; D012878:Skin Neoplasms / Q000556:secondary*; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology