Late Recurrence of Gastric Signet-Ring Cell Carcinoma Presenting as Pulmonary Metastasis 18 Years after Gastrectomy: A Case Report and Literature Review.

A 77-year-old woman presented with anorexia and weight loss. Chest computed tomography revealed a pulmonary mass and diffuse ground-glass opacity. She had undergone gastrectomy for gastric signet-ring cell carcinoma 18 years previously. A biopsy revealed poorly differentiated adenocarcinoma with signet ring cells. Treatment was initiated after the diagnosis of primary lung cancer. A temporary response was achieved; however, the patient died eight months later. Subsequent immunohistochemical findings were similar to the pathological findings obtained 18 years earlier, thus indicating gastric cancer recurrence. This case highlights the possibility of a late recurrence after surgery for gastric cancer.