This case suggested that gastrinoma/type 2 gastric neuroendocrine tumor-associated hypergastrinemia led to diminished E-cadherin expression and promoted carcinogenesis of signet ring cell carcinoma (29), which could also explain the frequent occurrence of carcinoma in patients with type 1 gastric neuroendocrine tumor. The gene discussed is CDH1; the disease is gastrin-producing neuroendocrine tumor.