Ménétrier's disease with coexistent signet ring cell carcinoma: a rare presentation with peritoneal metastasis.

Ménétrier's disease (MD) is an uncommon hypertrophic protein-losing gastropathy marked by hypertrophied gastric rugae and hypoalbuminaemia. While MD increases the risk of gastric adenocarcinoma, its correlation with signet ring cell carcinoma (SRCC) is exceptionally uncommon. We present a woman in her 50s, who had abdominal pain and emesis. Oesophagogastroduodenoscopy demonstrated significantly hypertrophied rugal folds accompanied by oedematous mucosa, whereas histopathological analysis indicated foveolar hyperplasia compatible with mucosal disease. A minor concentration of signet ring cells was also seen, corroborated by periodic acid Schiff (PAS) staining. Positron emission tomography (PET) imaging exhibited low-grade fluorodeoxyglucose uptake and omental stranding, whereas ascitic fluid and omental biopsy confirmed metastatic SRCC deposits. The case was addressed with palliative chemotherapy. This appears to be the inaugural documented instance of MD linked to SRCC from the Indian subcontinent. This research emphasises the significance of thorough histological analysis in MD, since the distinctive foveolar hyperplasia may conceal modest malignant foci.