Lower Limb Edema Caused by Metastatic Signet Ring Cell Stomach Cancer

Overall gastric cancer incidence is decreasing, but incidence of gastric signet ring cell carcinoma has been rising. The diagnosis can be challenging. It has a poorer prognosis because it tends to be diagnosed at advanced stages. Lymphedema is a rare presentation. We report a rare presentation of signet ring cell carcinoma in a 49-year old male, with no underlying medical condition. The patient presented with lymphedema of lower limbs, scrotum and abdominal wall. LEARNING POINTS: Signet ring cell carcinoma tends to have an infiltrative behavior. Endoscopic analysis may not lead to any macroscopic finding. In highly suspicious cases, endoscopic exploration should be complemented with an endoscopic ultrasound or blind random biopsies.