Revista ABCd (São Paulo). 09 Apr, 2015

Hereditary diffuse gastric cancer: laparoscopic surgical approach associated to rare mutattion of CDH1 gene

Eurico Cleto Ribeiro de CAMPOS
Saturnino RIBEIRO
Rafaella Ribas MURATORI
Teresa Cristina Santos CAVALCANTI
DOI: 10.1590/S0102-67202015000200017


Gastric cancer sets among the five most prevalent cancer in Brazil. For the year 2014, according to the National Cancer Institute (INCA), were expected 20,390 new cases with 13,328 deaths from the disease3.

Despite the identification of risk factors for the occurrence of neoplasia1, approximately 80% of cases are sporadic and not associated with risk factors. Even less frequent, it is the hereditary cases and associated with mutation of the HRC 1 gene, determining the occurrence of Cancer Hereditary Diffuse Gastric Syndrome. It corresponds to 3% of cases of gastric cancer7,10.

Patients mutation CDH1 gene carriers have shown gastric cancer with more adverse prognosis, as the presence of signet ring cells, poorly differentiated tumors and diffuse histological pattern, making also important to identify families suffering from chromosomal gene changes and syndrome determinants to allow early diagnosis and preventive treatment7,10.

As for the surgical treatment of hereditary or not gastric cancer, laparoscopy has demonstrated oncologic results similar to laparotomy approach, and lower morbidity, with patients returning earlier to their activities4.

This study aims to report a case diagnosed clinically and genetically, with treatment done through laparoscopic radical gastrectomy.


Man with 33y was admitted in July 2012 at the General Surgery Service of the Hospital of the Military Police of Paraná, asymptomatic and without comorbidities, but with a family history of gastric cancer in reporting two first-degree relatives with a diagnosis of cancer, one of them younger than 50 years (Figure 1A). After the endoscopy (Figure 1B), was identified ulcerated lesion in the gastric body with positive pathology for adenocarcinoma with histological pattern of signet ring cells (Figure 1C).

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