Primary Signet Ring Cell Carcinoma Research Articles

Effect of chemotherapy on prognosis in patients with primary pancreatic signet ring cell carcinoma: A large real-world study based on machine learning.

Primary pancreatic signet ring cell carcinoma (PSRCC), an extremely rare histologic variant of pancreatic cancer, has a poor prognosis. This study aimed to investigate the prognostic value of chemotherapy in PSRCC. Patients with PSRCC between 2000 and 2019 were identified using the Surveillance Epidemiology and End Results (SEER) database. The main outcomes in this study were cancer-specific survival (CSS) and overall survival (OS). The baseline characteristics of patients were compared using Pearson's Chi-square test. Kaplan-Meier analysis was used to generate the survival curves. Least absolute shrinkage and selection operator (LASSO), univariate and multivariate Cox regression models, and Random Survival Forest model were used to analyze the prognostic variables for OS and CSS. The variance inflation factors (VIFs) were used to analyze whether there was an overfitting problem. A total of 588 patients were identified. Chemotherapy was an independent prognostic factor for OS and CSS, and significantly associated with OS (HR = 0.33, 95% CI = 0.27-0.40, P <0.001) and CSS (HR = 0.32, 95% CI = 0.26-0.39, P <0.001). Chemotherapy showed beneficial effects on OS and CSS in patients with PSRCC and should be recommended in clinical practice.

Primary signet-ring cell carcinoma of the bladder treated with laparoscopic radical cystectomy: a case report.

Primary bladder adenocarcinomas comprise 0.5-2% of all epithelial bladder neoplasms. Of these, primary signet-ring cell carcinoma of the bladder is particularly rare, accounting for 0.24% of all bladder malignancies. This tumor is frequently diagnosed at an advanced stage and has a poor prognosis. No standard treatment has yet been established. We here report a patient in whom laparoscopic cystectomy following neoadjuvant chemotherapy was effective. Our patient was a 69-year-old man who had had microscopic hematuria, undergone transurethral resection of a mass in the bladder, and been diagnosed pathologically with a primary signet-ring cell carcinoma of the bladder. No metastases were detected on computed tomography. The patient was treated with a combination of paclitaxel, cisplatin, and gemcitabine prior to undergoing laparoscopic cystectomy. The histopathological diagnosis on this operative specimen was dysplasia and no metastases were detected in the dissected lymph nodes. Complete remission has now been maintained for 9years.

Endoscopic criteria for early differential diagnosis of gastritis-like form of primary non-Hodgkin's lymphomas and gastric cancer: A prospective study

Aim. To reveal and study basic endoscopic differential-significant criteria characterizing gastric-like form of primary non-Hodgkin's lymphoma (NHL) from adenocarcinoma and signet-ring cell carcinoma (SRCC) of the stomach.&#x0D; Materials and methods. In the prospective study, based of Blokhin National Medical Research Center of Oncology in the period from 2019 to June 2023, 106 patients with gastritic-like forms of primary NHL, adenocarcinoma and SRCC of the stomach were analyzed. Complex endoscopic study included examination in the modes of white light, magnification, narrow-band imaging (NBI, BLI, LCI) was done.&#x0D; Results. All patients were divided into three groups: MALT gastric lymphoma (38 patients, 35.8%), gastric adenocarcinoma (33 patients, 31.1%), and SRCC (35 patients, 33.1%). At MALT-lymphoma the tumor was localized in the antrum of the stomach (52.6%),adenocarcinoma and SRCC – in the body (45.5 and 60%). In the tumor structure in MALT-lymphoma of the stomach in 100% of cases multiple point areas of microdepressions and multicenter character of the lesion were determined. At adenocarcinoma – depressed area in the central part of tumor (45.5%), at SRCC – extended areas of microdepressions (51.4%) and multicentric character of lesions. At MALT-lymphoma the pit pattern in 63.2% is of "balloon" type, vascular – of tree-like type (84.2%). In adenocarcinoma the vascular pattern was of the loop-type (42.4%), in SRCC – of the corkscrew-type (74.3%). Demarcation line was observed only in adenocarcinoma (100%). At endosonographic study at MALT-lymphoma the tumor was coming from deep layers of mucous coat (100%), changes of regional lymph nodes (LN) were absent, at adenocarcinoma – from mucous membrane (100%), LN were not changed, at SRCC – submucous spread of tumor (100%), changes in LN (40%).&#x0D; Conclusion. Complex endoscopic examination is necessary to improve the quality of endoscopic examination of malignant gastric-like tumors, to determine the depth of invasion and spread of the tumor process, to assess the regional lymph drainage.

Primary Signet Ring Cell Mucinous Adenocarcinoma of the Urinary Bladder: A Rare Case Report

Primary ‘signet ring mucinous adenocarcinoma’ is most commonly located in the stomach. The bladder is an uncommon presentation site for the primary location of this tumor. Mucinous signet-ring adenocarcinoma with urinary bladder as the primary origin is uncommon, accounting for fewer than two percent of all upper urinary tract carcinomas. The presence of signet ring cells, which is caused by compression and displaced nucleus of the cell into a crescent placed in the periphery along the cell wall, is a distinguishing feature of signet ring cell carcinoma. These cells are loaded with cytoplasmic mucus-containing vacuoles. Lower than one-third of primary bladder signet ring cell carcinoma cases show this gross morphology showing linitis plastica pattern with subepithelial infiltration without producing an exophytic mass in a pure signet ring cell carcinoma. Because this tumor shares histological features with the adenocarcinomas originating in several other sites, such as the prostate, digestive tract, and reproductive system, immunohistochemistry tests are required to confirm the bladder as the primary origin. Owing to the paucity of the neoplasm and the difficulty in locating the underlying tumor, site identification is frequently prolonged, leaving palliative care as the only choice for roughly half of the patients. This study depicts a rare case report of primary vesicular signet ring cell mucinous adenocarcinoma that considerably invades the pelvis and retroperitoneum's prostate and lymph nodes. This case emphasizes the significant characteristics of bladder mucinous adenocarcinoma, such as the sequence of tumor spread, the propensity for preliminary diagnostic errors, the microscopic pattern, and the significance of immunohistochemistry for defining its primary root from the bladder and selecting the most suitable intervention from the start.

Metastasis of primary signet ring cell carcinoma of prostate to bone marrow: A rare occurrence with review of literature.

We report a case of a 65-year-old male who presented with multiple enlarged intraabdominal lymph nodes with lytic lesions over pelvic and lumbar vertebrae. His serum prostate-specific antigen (PSA) was markedly raised. Bone marrow investigation revealed the presence of diffuse infiltration of single cells having hyperchromatic nuclei, moderate amount of eosinophilic cytoplasm, and eccentrically placed nuclei resembling signet ring cells. Hence, a diagnosis of metastatic signet cell carcinoma of prostate was made on bone marrow biopsy. This variant of prostatic carcinoma is very rare and accounts for only 2.5% of all prostatic adenoacarcinomas that make our case worth reporting. To emphasize the rare occurrence of this variant, we performed a Pubmed-based literature review of 25 years.

Multivisceral resection for primary pancreatic signet ring cell carcinoma.

Primary pancreatic signet ring cell carcinoma (PPSRCC) is a rare and aggressive tumor with poor prognosis. Here, we report a case of PPSRCC treated with curative surgery. A 49-year-old man presented with right mid-abdominal pain. Imaging tests showed a 3.6cm tumor extending around the head of the pancreas, the second portion of the duodenum, and the retroperitoneum. Involvement of the right proximal ureter resulted in moderate right hydronephrosis. A subsequent tumor biopsy revealed suspected pancreatic adenocarcinoma. No apparent lymph node or remote metastases were observed. The tumor was considered resectable, and radical pancreaticoduodenectomy was planned. Pancreaticoduodenectomy, right nephroureterectomy, and right hemicolectomy were conducted to resect the tumor en bloc. Final pathology revealed a poorly differentiated ductal adenocarcinoma of the pancreas with signet ring cells infiltrating the right ureter and transverse mesocolon (pT3N0M0, stage IIA, according to UICC for International Cancer Control TNM classification). The postoperative course was uneventful, and oral fluoropyrimidine (S-1) was administered as adjuvant chemotherapy for 1year. At the 16-month follow-up, the patient was alive without any evidence of recurrence. Pancreaticoduodenectomy with right hemicolectomy and right nephroureterectomy was performed for curative resection of PPSRCC infiltrating the transverse mesocolon and right ureter.

Rare Primary Signet Ring Cell Carcinoma of the Bladder Cancer

Rare Primary Signet Ring Cell Carcinoma of the Bladder Cancer

Primary signet ring cell adenocarcinoma as a rare cause of colonic stenosis in a young patient with Crohn’s disease – the case report

Summary: Signet ring cell carcinoma (SRCC) is a rare type of highly malignant adenocarcinoma that produces mucin and predominantly affects the stomach, ovaries, and the small intestine. Primary localisation in the colon is rare, and the prognosis of this type of adenocarcinoma is very poor. We present a case report of a 44-year-old woman who suffered from Crohn‘s disease beginning in the year 2000. During the last three years of her treatment, she was treated using bio­logical therapy with ustekinumab. The treatment led to clinical, laboratory, and endoscopic remission. In February 2021, she had widely metastatic primary signet ring cell carcinoma of the colon, which mimicked the IBD activity in the case of her colon obstruction. Because of the extensive infiltration of her liver and peritoneum at the time of the dia­gnosis, in addition to the symptoms of the passage disorders she was experiencing, she proceeded with an end ileostomy and palliative treatment was started. The patient‘s prognosis was unfavourable, and she died within 5 months of the dia­gnosis in hospice care. Key words: primary signet ring cell carcinoma – colon cancer – Crohn‘s disease – colonic stenosis

A model for predicting overall survival in bladder cancer patients with signet ring cell carcinoma: a population-based study

IntroductionThis study is to examine the predictors of survival and to construct a nomogram for predicting the overall survival (OS) of primary bladder signet ring cell carcinoma (SRCC) patients based on the analysis of the Surveillance, Epidemiology, and End Results (SEER) database.MethodsA total of 219 eligible patients diagnosed with SRCC were analyzed using the 2004–2015 data from SEER database. Univariate and multivariate Cox regression were used to determine independent prognostic factors, followed by development of a nomogram based on the multivariate Cox regression models. The consistency index (C-index), receiver operating characteristic (ROC) curve, and calibration curve were used to validate the prognostic nomogram.ResultsThe nomograms indicated appreciable accuracy in predicting the OS, with C-index of 0.771 and 0.715, respectively. The area under the curve (AUC) of the nomogram was 0.713 for 1 year, 0.742 for 3 years, and 0.776 for 5 years in the training set, while was 0.730 for 1 year, 0.727 for 3 years, and 0.697 for 5 years in the validation set. The calibration curves revealed satisfactory consistency between the prediction of deviation correction and ideal reference line.ConclusionsThe prognostic nomogram developed in the analytical data of SEER it provided high accuracy and reliability in predicting the survival outcomes of primary bladder SRCC patients and could be used to comprehensively assess the risk of SRCC. Moreover, they could enable clinicians to make more precise treatment decisions for primary bladder SRCC patients.

Primary signet ring cell carcinoma of prostate: A rare case report and review of literature.

Primary signet ring cell carcinoma (PSRCC) of the prostate is an extremely rare variant of prostatic adenocarcinoma. A PubMed search of the English language literature from January 2000 to June 2020 using the keywords "signet ring cell carcinoma" and "prostate," identified 20 cases of PSRCC of the prostate. On the basis of the combined data from this study and the literature review, 21 such patients were evaluated for clinical characteristics, histologic diagnoses, special and immunohistochemical staining, and treatment. The mean age at the diagnosis was 68.47 years (range 50-85 years). The prostate-specific antigen (PSA) levels varied from 0.19 to 6658 ng/mL, with a mean of 509.15 ng/mL. Most (50%) presented with Stage 3 cancer. The most common Gleason grade group was 5 (Gleason score 9 to 10), seen in 61.5%. The extent of signet ring cell involvement of the specimen when reported was documented as more than 20% of the tumor-containing signet ring cells, with a range of 25%-90%. For pathologic diagnosis, the most common special stains performed were periodic acid-Schiff and Alcian blue, and among the immunohistochemical stains, the most common were PSA, CK20, and prostate-specific acid phosphatase. A detailed clinicoradiological and pathological workup is essential to rule out primary from other common sites, in view of its grave prognosis and lack of an established treatment protocol.

An early-stage primary signet ring cell carcinoma of the colon.

Primary signet ring cell carcinoma of the colorectum is rarely detected at an early stage,here,we present a case with early stage primary signet ring cell carcinoma of the colon, and the patient was treated at an early stage, and the prognosis was well. We also provide endoscopic and histological characteristics of early stage SRCC.

Primary signet ring cell carcinoma of the lung: A case report

Signet Ring Cell Carcinoma (SRCC) also known as mucocellular carcinoma, it is a cancer cell with a lot of mucus. Primary lung SRCC is an extremely rare type of lung cancer malignancy. At present, there is no standard treatment scheme for primary pulmonary SRCC at home and abroad. We describe the clinical symptoms of a unique primary lung SRCC and the evaluation of its efficacy after targeted drug therapy. The results suggest that after the immunohistochemical results of ALK are positive, the use of biological targeted therapy may be a better choice.

Effect of Surgery Combined with Gemcitabine and Oxaliplatin Chemotherapy on Primary Signet Ring Cell Carcinoma of Bladder: A Case Report

Background: Primary signet ring cell carcinoma of the bladder is an extremely rare and highly invasive variant of primary bladder cancer. When tumors are found, they usually show high level and high-stage lesions and diffuse invasion of the bladder wall, and most tumors do not grow in the cavity. Most patients have no specific symptoms at the beginning, which leads to delayed diagnosis and treatment and poor prognosis.

S2046 High-Grade Mucinous Adenocarcinoma of the Appendix With Signet Features and Omental Metastasis

Introduction: Primary adenocarcinoma of the appendix is an uncommon malignancy of the gastrointestinal tract. It was first described in 1882 and constitutes around 0.12 to 2.6 cases per one million people per year. In addition, signet-ring cell carcinoma of the appendix is extremely rare, it constitutes approximately 4% of all primary appendiceal neoplasms. There are few reported cases of primary signet cell appendiceal carcinoma. In this present report, we describe a rare case of primary signet ring cell carcinoma of the appendix with omental metastases in an 81-year-old male who underwent laparoscopic appendectomy. Case Description/Methods: We present a case of an 81-year-old male who had prior negative esophagogastroduodenoscopy (EGD) and colonoscopy in 2017 who presented to an urgent care in January 2021 with abdominal pain. Lab work was unremarkable, and the patient was sent home with instructions to visit the emergency department (ED) if he experienced fever, increased abdominal pain, or blood in the stool. Patient presented to the emergency department with increased abdominal pain in April 2021, and Computed Tomography (CT) scan of abdomen and pelvis with intravenous contrast showed a cystic appendiceal lesion with right peritoneal nodularity suspicious for peritoneal carcinomatosis. Therefore, the patient underwent appendectomy the following day revealing poorly differentiated, high-grade appendiceal adenocarcinoma with signet ring features, pT4a disease. Patient had a diagnostic laparoscopy in June 2021 and was found to have diffuse peritoneal carcinomatosis. Multiple biopsies were obtained and came back positive with high-grade mucinous adenocarcinoma with signet ring features. Patient agreed to pursue systemic chemotherapy. He was initiated on Capecitabine (Xeloda) 2000 mg tab PO, twice daily for 14 days and off for 7 days. Bevacizumab (Avastin) 7.5 mg IV infusion every 3 weeks (Figure). Discussion: Patients with appendiceal neoplasms may have vague lower abdominal pain but are usually asymptomatic with incidental diagnosis on imaging or appendectomy. Signet ring adenocarcinoma of the appendix typically secretes mucin leading to metastasis throughout the peritoneum and eventual obstruction. Treatment is based on stage and histology. Surgical resection and peritoneal debulking is possible. High-grade tumors require further prospective trials to evaluate treatment, but treatment options include surgical management, HIPEC, and systemic chemotherapy.Figure 1.: Histologic examination showing a signet cell carcinoma of the appendix infiltrating the peritoneum and diaphragm. (A) right lower quadrant peritoneum biopsy, (H&E stain 100x): High grade mucinous carcinoma peritonei with signet ring cells. Pool of mucin with a cluster of epithelium that shows signs of metastatic carcinoma (enlarged nuclei, atypia, pleomorphic changes). (B, C, and D) Right diaphragm peritoneum biopsy. High grade mucinous carcinoma peritonei with signet ring cells. Image B at 100x, C at 200x, and D at 400x. (E & F) immunohistochemical cytokeratin stain (AE1/AE3) shows strong positivity of high grade carcinoma. E at 100x, and F at 400x.

S2124 Shisto or No?: A Rare Case of Signet Ring Cell Carcinoma of the Rectum Mimicking Schistosomiasis

Introduction: Signet ring cell carcinoma (SRCC) of the rectum is a rare type of colorectal cancer with an incidence of less than 2%. SRCC is associated with poor prognosis, and often diagnosed at an advanced stage. While rare in the general population, SRCC occurs in up to 25% of schistosomiasis associated colorectal cancer. We report a case of SRCC in a patient with clinical features that mimicked colorectal and genitourinary schistosomiasis. Case Description/Methods: A 38-year-old male immigrant from rural Cuba presented with a 3 month history of urinary retention, intermittent fevers, and hematuria requiring placement of indwelling foley. Physical exam and vital signs were otherwise normal. Hb was 8.5 G/DL, MCV 85 fl, Creatinine 1.7 mg/dL. CT of the abdomen and pelvis with IV contrast revealed severe bilateral hydroureteronephrosis, concentric bladder wall thickening, splenomegaly, enlarged bilateral inguinal lymph nodes, and concentric submucosal thickening of the distal sigmoid/rectum with extensive calcifications. Colonoscopy revealed severe, diffuse, circumferential inflammation, narrowing, and ulceration from anus to sigmoid. While colitis was suspected, rectosigmoid biopsy showed mucinous adenocarcinoma with signet ring cell features. While we suspected schistosomiasis, Schistosoma IgG Ab was normal. The patient was advised to undergo further workup and chemotherapy, but he declined further treatment (Figure). Discussion: Schistosomiasis is a parasitic disease known to have an association with bladder neoplasia and gastrointestinal manifestations in the form of colitis and rectal calcifications. We suspect that due to his extensive rectosigmoid cancer our patient presented with features mimicking schistosomiasis, namely extrinsic genitourinary compression causing hydroureteronephrosis with hematuria, and cancer appearing like colitis. This case is instructive in that we are reminded of the interesting presentation of schistosomiasis as well as the occasional presence of signet cell cancer in the lower gastrointestinal tract. While the majority of SRCC arise in the stomach, occasionally this entity can present as an isolated primary SRCC of the rectum. Treatment with targeted therapy and chemotherapy have limited effect on improving survival. In conclusion, though SRCC of the rectum is rare, clinicians should consider this in the differential in patients presenting with risk factors for both schistosomiasis and SRCC of the rectum.Figure 1.: A, CT of the pelvis with IV contrast showing concentric submucosal thickening of the distal sigmoid/rectum with calcifications. B, Colonoscopy showing severe circumferential inflammation, narrowing, and ulceration of the sigmoid colon.

Clinicopathological Characteristics and Prognostic Factors of Primary Bladder Signet Ring Cell Carcinoma

Introduction The aim of this study is to examine the treatment pattern and predictors of long-term survival of patients with primary signet ring cell carcinoma (PSRCC) of the urinary bladder based on the analysis of the SEER database. Methods The 3-year and 5-year overall survival (OS) and cancer-specific survival (CSS) were calculated using the Kaplan–Meier method. Then, we compared the CSS curves by the log-rank test. The independent risk factors were determined using univariate and multivariate Cox regression. Results The 3-year OS and CSS rates for PSRCC of the bladder were 25.3% and 33.3%. The 5-year OS and CSS rates for the entire cohort were 16.4% and 25.2%. The CSS rates, respectively, were 0, 25.0, 66.7, 33.2, 42.4, and 31.7% at 3 years and 0, 25.0, 34.3, 24.1, 27.2, and 31.7% at 5 years for none, transurethral resection of the bladder (TURB), partial cystectomy, radical cystectomy with reconstruction, pelvic exenteration, and other surgeries (P = 0.001). Multivariate analyses showed independent risk factors only including T stage, M stage, lymph node removal, and surgical approach. Conclusions T stage, M stage, lymph node removal, and surgical approach are independent risk factors of PSRCC of the urinary bladder. TURB and radical cystectomy with reconstruction appear to provide a better outcome.

Primary signet-ring cell carcinoma of the extrahepatic bile duct: A case report

BACKGROUNDSignet ring cell carcinoma (SRCC) is a specific type of mucinous secretory adenocarcinoma, which contains abundant mucus in the cytoplasm and pushes the nucleus to one side of the cell membrane, forming a round or oval, and the nuclear deviations give the cells a signet ring-like appearance. SRCC often originates in the gastrointestinal tract, especially in the stomach. However, primary SRCC of the extrahepatic bile duct is extremely rare. Therefore, little is known about its epidemiology, treatment, and prognosis.CASE SUMMARYAn 82-year-old female was admitted with abdominal pain, jaundice, and skin pruritus for 2 mo. She had no specific family history. Physical examination presented normal vital signs, icteric sclera, visible jaundice, and mild tenderness in the right upper abdominal quadrant. Tumor-related cell markers were within normal values. Contrast-enhanced computed tomography revealed a thickened wall of the common bile duct, strengthened with intrahepatic bile duct dilation and multiple round-like lesions in the liver. In addition, the lymph nodes in the hepatic hilum area, the pancreatic head area, and around the abdominal aorta were enlarged. Thus, a preoperative diagnosis of cholangiocarcinoma was established. To alleviate jaundice and prolong the overall survival, percutaneous transhepatic cholangiopancreatic drainage (PTCD) was performed. During the operation, segmental stenosis of the extrahepatic bile duct and a vine-like expansion of the intrahepatic bile duct was observed. Furthermore, a biliary biopsy was performed under fluoroscopy to determine the nature and origin of the lesion. The pathological diagnosis of the biopsy was SRCC. Finally, a diagnosis of primary SRCC of extrahepatic bile duct with distant lymph node metastasis and multiple liver metastases was made based on the radiographic, PTCD, and pathological characteristics. The tumor was diagnosed as T3N1M1 stage IV. Despite our aggressive approach, the patient died of liver failure after 1 mo.CONCLUSIONThis is the only case report on primary SRCC of the extrahepatic bile duct with distant organ metastasis to date.

PRIMARY MUCINOUS ADENOCARCINOMA OF THE LUNG WITH SIGNET-RING CELLS AND ALK REARRANGEMENT: A CASE REPORT

TYPE: Case Report TOPIC: Lung Pathology INTRODUCTION: The presence of malignant signet-ring cells is more commonly seen in the adenocarcinomas, particularly those of the gastrointestinal tract and breast. In a study with 24,171 patients with signet-ring cell carcinoma (SRCC), it was found that only 3.1% of the cases have a primary pulmonary origin, making the study of SRCC of the lung restricted to reports and case series. CASE PRESENTATION: We present the case of a 70-year-old patient with a history of retroperitoneal liposarcoma and papillary thyroid carcinoma in whom a primary pulmonary adenocarcinoma of mucinous pattern with signet-ring cells and ALK rearrangement was diagnosed. DISCUSSION: The World Heart Organization (WHO) had included the SRCC subtype. However, since 2015 WHO classification, it is recognized only as cytologic features rather than primary histologic subtype. The incidence of primary SRCC of the lung is between 0.14 to 1.9% of all lung tumors. The differences in incidence rates lie in the definition since clear diagnostic criteria have not been established. Its presentation is slightly more common in men (52.7%) and Caucasian patients (82.2%), with a mean overall survival duration of 8 months. Patients presenting with the EML4-ALK fusion protein have unique pathological and physiological characteristics. Several reports have shown that it predominates in a young female population with adenocarcinoma and without exposure to tobacco. However, these are not consistent data in all studies. CONCLUSIONS: Lung cancer has a very heterogeneous presentation. We emphasize the importance of approaching these patients with histopathological, immunohistochemical, and molecular biology studies. DISCLOSURE: Nothing to declare. KEYWORD: pulmonary signet ring cell carcinoma

Could combination of radical hysterectomy and radiation effective in the treatment of primary cervical signet ring cell carcinoma?: A rare case report.

IntroductionPrimary signet-ring cell carcinoma (PSRCC) of the uterine cervix mostly occurs due to the metastasis from the primary organ, such as the gastrointestinal tract or breast. This case describes the cervical PSRCC and its management as a rare case.Presentation of caseThe 39-year-old female came to undergo cancer screening. Visual Inspection with Acetic Acid (VIA) examination result was negative with the feature of severe cervicitis, and then the patient was given Trichloroacetic Acid (TCA) procedure. Three weeks after TCA's procedure, speculum examination found morphological features of cervix malignancy. Cervical biopsy examination showed mucinous adenocarcinoma, signet ring cell variant, with lymphovascular invasion. Endometrial microcurettage specimen do not contain tumor mass.DiscussionThe risk factor for cervical cancer in this patient was early sexual intercourse. We suggested stage IB2 cervical cancer because the tumor size was 2 cm until 4 cm, there was no spreading to nearby lymph nodes nor distant sites. Then patient had performed a radical hysterectomy procedure with ovary transposition and a series of radiation therapy. The patient was in good condition and no metastases were found in the imaging study.ConclusionThe treatment of PSRCC of the uterine cervix is challenging. It was established from intraoperative findings, histopathology, and immunohistochemistry examination. The radical hysterectomy adjunct to radiation was effective in the treatment of the PSRCC of the uterine cervix.

Primary prostatic signet ring cell carcinoma in elderly with obstructive uropathy: a case report

BackgroundPrimary signet-ring cell carcinoma (SRCC) of the prostate is a rare and aggressive subtype of prostate adenocarcinoma with a poor prognosis, with only approximately 60 cases reported worldwide.Case presentationA 62-year-old man presented with acute urinary retention and hematuria, after a year’s history of lower urinary tract symptoms. Digital rectal examination revealed an irregular and hard prostate. Flexible cystoscopy showed bladder base infiltration by the enlarged prostate obscuring both ureteric orifices, necessitating nephrostomy and subsequent bilateral antegrade stenting to relieve the obstruction and improve his renal function. Transrectal ultrasonography biopsy of the prostate was performed revealing histological features of SRCC. Due to its rarity, there is currently no standardized treatment approach and it is often similarly treated according to the traditional management of prostate adenocarcinoma.ConclusionsSRCC of the prostate is a rare and aggressive subtype of acinar adenocarcinoma with no established guidelines. Histological criteria for SRCC of the prostate are highly variable in the available literature. It is important to differentiate between the primary and metastatic SRCC of the prostate as both are managed differently. However, the overall prognosis remains poor in general.