What happened, in summary

A 23-year-old woman underwent genetic testing because hereditary diffuse gastric cancer affected her family. She carried the same monoallelic deletion of exons 1-2 of the CDH1 gene found in her older brothers. CT scans and endoscopic biopsies showed no active gastric cancer, but she chose preventive total gastrectomy because of the inherited risk.

Pathology after surgery revealed multiple microscopic foci of signet ring cells in the stomach lining, with the largest focus measuring about 1 mm. The cancer remained confined to the lamina propria, all 23 examined lymph nodes were negative, and no other organ showed malignancy.

She recovered from the gastrectomy without a major surgical complication and was discharged after 7 days once pain and nutrition were adequately managed. During later follow-up she also underwent surgery for symptomatic gallstones. At the latest follow-up, she continued follow-up with no evidence of disease.