Extreme Rare Case of Primary Signet Ring Cell Carcinoma of Gall Bladder-Case Report

Ranjit Kumar Padhiari,Niyaz Ahmed,Vishnu Kurpad,G P Praveen,M K Ramesh,Basavaraj Talwar

doi:10.5539/cco.v3n1p25

Abstract

Primary carcinoma of the gallbladder is an uncommon malignancy with a variable incidence. Women are affected generally than men (3-4:1) with higher incidence in increasing age. The signet ring cell sub type of adenocarcinoma is a rare and aggressive variant carrying worse prognosis. We report a case of primary signet ring cell carcinoma of gallbladder in a 55yr old woman. Ultrasound showed thickened gallbladder with multiple gallstones. Patient underwent open cholecystectomy. Grossly gallbladder was thickened with multiple stones. Histopathological examination revealed sheets of signet ring cells infiltrating full thickness of the wall. H&E, periodic acid–Schiff (PAS), Alcian blue & Cytokeratin 7 stains confirmed presence of signet ring cells. Post-op Endoscopy with biopsy was done to rule out primary in stomach. Early diagnosis and new lines of treatment in chemotherapy or new biological therapy should be encouraged to improve the survival and life quality.

Highlights

Gallbladder carcinoma is the fifth most common malignant tumor of the gastrointestinal tract and the most frequent malignant neoplasm of the biliary tract
We report a case of primary signet ring cell carcinoma of gallbladder in a 55yr old woman
Gallbladder carcinoma is more common in females than males and its incidence shows the tendency to increase with age (Donohue et al, 1998; Pesic et al, 2002)

Summary

Introduction

Gallbladder carcinoma is the fifth most common malignant tumor of the gastrointestinal tract and the most frequent malignant neoplasm of the biliary tract. More frequent in females than males (3 to 4:1), over 90% of the patients are 50 years of age or older (Donohue et al, 1998; Pesic, Karanikolic, Djordjevic, Gmijovic, & Basic, 2002). Signet ring cell carcinoma is a rare and aggressive variant of mucinous adenocarcinoma. These tumours show a growth pattern (linitis plastic aappearance) similar to that seen in gastric signet ring cell carcinoma (Murakata & Albores-Saavedra, 2004). It is necessary to exclude benign signet ring change, sometimes occurring in the gallbladder, which is confined to the mucosa and does not infiltrate the wall

Case History

Pathological Findings

Discussion

Conclusion