Signet ring-cell colorectal adenocarcinoma: review and clinical case

Abstract

Colorectal cancer is one of the most common malignancies in the general population and has many histological subtypes. Signet-ring cell adenocarcinoma is a rather rare variant of this pathology. It is characterized by molecular genetic and morphological features that are absent in classical adenocarcinomas, which causes some nuances in the clinical course and approach to therapy of this type of tumor. In our clinical case, a 68-year-old patient went to a general practitioner with complaints of abdominal pain, changes in the act of defecation, and according to the primary physical and instrumental examination, he was diagnosed with chronic distal colitis, and later he was prescribed anti-inflammatory therapy. However, six months later, the patient went to the doctor again with complaints of worsening condition and symptoms, after examination, he was diagnosed with adenocarcinoma of the sigmoid colon, but due to low adherence to treatment, as well as late diagnosis, the patient died within six months. Surgical treatment of the patient was limited to resection of the sigmoid colon due to peritoneal adhesions. In the postoperative period, the development of fibrinous-purulent peritonitis and increasing cardiovascular failure were clinically noted. At autopsy, the histological variant of the lesion was changed to the signet-ring cell form with metastasis to the liver and greater omentum. Death occurred from disseminated intravascular coagulation syndrome with the development of acute renal failure and centrilobular necrosis of the liver. Clinical observation emphasizes the importance of introducing modern molecular diagnostic methods into wide practice.