Quality of Life Over Quantity: Conscious Refusal of Treatment and Stable Course of Gastric Signet-Ring Cell Carcinoma in a 94-Year-Old Woman

We report the case of a 94-year-old woman with histologically confirmed signet-ring cell carcinoma (SRCC) of the stomach (ICD-O-3.2 code 8490/3). The patient consciously declined oncological treatment and received only supportive and symptomatic care. Over a follow-up period of at least 12 months, she has remained alive, active, cognitively intact, and socially engaged. Despite the typically aggressive histological subtype, the disease followed an indolent clinical course. This case highlights the biological heterogeneity of SRCC and the importance of personalised oncogeriatric decision-making that prioritises autonomy and quality of life in the oldest-old population, consistent with contemporary European Society for Medical Oncology (ESMO)/International Society of Geriatric Oncology (SIOG) recommendations and palliative-oriented medical principles.

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