en Surgery Surgery case report case report <p> <strong> Absract </strong></p><p>  Gastric cancer is the fourth most common cancer and the second leading cause of </p><p>  cancer death. Most cases are sporadic and only 10% of patients, show familial clustering. Among these patients, 1 to 3 % have hereditary diffuse gastric cancer </p><p>  (HDGC), which is autosomal-dominant and present in younger ages. Mutations in Ecadherin gene CDH1 has been identified in 30 to 50% of patients. Because endoscpoic surveillance is not effective in identifying early HDGC, gene-directed prophylactic gasterectomy is recommended for CDH1 muta-tion carriers. But in most carriers who underwent prophylactic ga-strectomy, histological examinations on the resected stomach revealed foci of diffuse gastric cancer. It shows that gasterectomy </p><p>  could be curative instead of prophylactic in these cases. Individuals from families </p><p>  with HDGC should be recommended to genetic testing and in patients that have a </p><p>  CDH1 gene mutation, total gasterectomy is in-dicated. We are presenting a 27 year </p><p>  old patient with striking history of familial gastric cancer and positive E-cadherin </p><p>  gene mutation who underwent prophylactic gasterectomy. </p><p>  </p> CDH1 mutations, hereditary diffuse gastric cancer, prophylactic total gastrectomy 169 174 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-122&slc_lang=en&sid=1 Shirzad Nasiri nasiri@razi.tums.ac.ir 2003194753284600873 2003194753284600873 Yes Tehran University of Medical Sciences. Address: General surgery ward,Shariati Hospital, North kargar St. Tehran, Iran Anushiravan Hedayat hedayat@tums.ac.ir 20031947532846001046 20031947532846001046 No Tehran University of University of Medical Sciences Reza Malekzadeh malek@ams.ac.ir 20031947532846001047 20031947532846001047 No Tehran University of Medical Sciences Zhamak Khorgami khorgami@tums.ac.ir 20031947532846001048 20031947532846001048 No Tehran University of Medical Sciences Nassim Sodagari nassimso@yahoo.com 20031947532846001049 20031947532846001049 No Tehran University of Medical Sciences