Primary Signet-Ring Cell Carcinoma of the Urinary Bladder in an Atomic Bomb Survivor: A Case Report

Abstract

Primary signet-ring cell carcinoma of the urinary bladder is a disorder with little detailed information because it has an extremely low incidence and an unfavorable prognosis. We report the case of an 80-year-old male patient with primary signet-ring carcinoma of the bladder. The patient was a long-lived atomic bomb survivor of Hiroshima. He complained of asymptomatic gross hematuria while under successful endocrine treatment for organ-confined prostate cancer. Magnetic resonance imaging showed diffuse thickening of the urinary bladder. Pathological specimens revealed an infiltrating growth of neoplastic cells with a signet-ring cell configuration. The o ral administration of t egafur-uracil (200 mg/m 2 per day) was initiated; however, the effect of this treatment was temporary. Fourteen months after the start of this treatment, the tumor had involved the bilateral intramural ureters and postrenal azotemia occurred because of bilateral hydronephrosis. Whether the prevalence of signet-ring cell carcinoma in the genitourinary tract is higher in atomic bomb survivors than in the general population remains much debated. The development of this rare and peculiar urothelial cancer after exposure to atomic bombing may give hints to the carcinogenic effect of ionizing radiation. doi: http://dx.doi.org/10.4021/wjnu99w