If a large fungating signet ring cell mass is discovered in the gastric antrum blocking the pyloric canal in a 24-year-old female. stage iv with metastasis to omentum. was it was there 1 year earlier?

Variable but mos-yrs: While tumor growth is always variable based on how aggressive the cells are when they first develop, typically early stage cancers are less aggressive and therefore a lower grade than more advanced tumors seem to be once they've accumulated more mutations as they dedifferentiate. That being said cancers grow and advance and most gastric ca's will take many month and even a year or so to spread.

Signet cell cancer: Stomach cancer with signet ring cell features on pathology is an aggressive and fast growing cancer which by virtue of omental/mesenteric or peritoneal involvement becomes stage 4 disease. I think this tumor probably grew in few months and not more than a year. Without treatment most patients only survive few months.

Aggressive cancer: Nobody knows for how long a large mass has been developing , growing in your stomach and spreading to the omentum. But aggressive cancer like this can grow quite rapidly. Signet cell ca was more likely to be found at a later stage, and more likely to have lymph node spread and metastasis on diagnosis- likely because their aggressiveness- compared to other types of stomach cancer.