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Abad-Licham M, Cotrina C, Guerrero A, Gómez K, Astigueta J. Primary signet ring cell carcinoma of the cervix: case report and literature review. Ecancermedicalscience 2024; 18:1671. [PMID: 38439801 PMCID: PMC10911662 DOI: 10.3332/ecancer.2024.1671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Indexed: 03/06/2024] Open
Abstract
Objective To report an infrequent case of primary signet ring cell carcinoma of the cervix (PSRCC), review the literature and evaluate the clinicopathological characteristics. Material and methods A 51-year-old female patient, with 3 years of disease characterised by gynaecologic bleeding and pelvic pain. On examination, cervix replaced by tumour and infiltrated parametria; with cytology and histology of adenocarcinoma with cells in a signet ring pattern. Disease extension studies were negative. Classified as PSRCC stage IIIB, chemotherapy and radiotherapy were indicated, but the patient died a month later. The bibliographic search included publications up to July 2023. Results 32 cases with a mean age of 47.6 years were identified. The most frequent symptoms were uterine bleeding and abdominal and pelvic pain. The initial stages were treated surgically, some with adjuvant chemotherapy and/or radiotherapy, with favourable responses; a difference from advanced cases. The average survival was 17.6 months. Conclusion PSRCC is rare, with 32 cases reported according to the review. The expression with immunohistochemical and molecular techniques for the human papilloma virus can help confirm the gynaecological primary, but its diagnosis is one of exclusion, since its morphological pattern is related to other primaries, mainly digestive.
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Affiliation(s)
- Milagros Abad-Licham
- Faculty of Medicine, Universidad Privada Antenor Orrego, Trujillo 13008, Perú
- Department of Oncological Pathology, Instituto Regional de Enfermedades Neoplásicas, Trujillo 13007, Peru
- Centre of Excellence in Oncological Pathology, Trujillo, Peru
- https://orcid.org/0000-0002-3530-6937
| | - Christian Cotrina
- Department of Oncology Surgery, Instituto Regional de Enfermedades Neoplásicas, Trujillo 13007, Peru
- https://orcid.org/0009-0006-8767-7314
| | - Andric Guerrero
- Department of Oncological Pathology, Instituto Regional de Enfermedades Neoplásicas, Trujillo 13007, Peru
- https://orcid.org/0000-0002-2619-1920
| | - Katherine Gómez
- Department of Oncological Pathology, Instituto Regional de Enfermedades Neoplásicas, Trujillo 13007, Peru
- https://orcid.org/0000-0002-9097-0224
| | - Juan Astigueta
- Faculty of Medicine, Universidad Privada Antenor Orrego, Trujillo 13008, Perú
- Department of Oncology Surgery, Instituto Regional de Enfermedades Neoplásicas, Trujillo 13007, Peru
- https://orcid.org/0000-0001-5984-3270
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Lazhar H, Slaoui A, Rostoum S, Caidi N, Chat L, Baydada A. Primary signet ring cell carcinoma of the cervix: About an uncommon case report. Int J Surg Case Rep 2023; 105:107950. [PMID: 36924600 PMCID: PMC10025990 DOI: 10.1016/j.ijscr.2023.107950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/12/2023] [Accepted: 02/21/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Cervix mucinous adenocarcinomas have been defined by WHO classification into different subtypes: gastric, intestinal and ring signet cell. Ring signet cell subtype represent a diagnostic challenge due to the small number of cases described in the literature. We report hereby the 31st case worldwide, which is all the more exceptional as its atypical clinical presentation with mainly urological clinical signs represented a real diagnostic challenge. CASE PRESENTATION We present the uncommon case of a multiparous, menopausal 68 years-old-woman, who presented in our department for pelvic pain evolving for 4 months associated with dysuria. Gynecological examination showed a bulging mass on the anterior vaginal wall with mucoid urinary discharge. Perineal ultrasound and pelvic MRI showed an anterior vaginal mass arising from the anterior vaginal wall, invading the bladder, urethra and respecting vagina's upper third and the rectum associated with multiple metastatic left iliac lymph nodes. Anatomopathological analysis revealed a moderately differentiated mucinous adenocarcinoma with a signet-ring cell appearance. IHC stain for P16, marker for high-risk HPV, was strongly positive. Due to the advanced stage, the patient was not a candidate for upfront surgery and received definitive chemoradiation with palliative intent. The patient succumbed to her disease after only one month of chemotherapy. CONCLUSIONS Primary signet ring cell carcinoma of the cervix is rare and associated with a poor outcome. Prognosis is related to the clinical stage. Differentiate primary from metastatic signet cell carcinoma is compulsory. IHC is very helpful but not decisive and the diagnosis is often made by exclusion.
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Affiliation(s)
- Hanaa Lazhar
- Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco
| | - Aziz Slaoui
- Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco; Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.
| | - Soufiane Rostoum
- Radiology Department Mother and Child, Children Hospital of Rabat, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco
| | - Nawfel Caidi
- Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco
| | - Latifa Chat
- Radiology Department Mother and Child, Children Hospital of Rabat, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco
| | - Aziz Baydada
- Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco
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Kim YH, Lee SJ, Lee SU, Hwang IS, Yim KI, Kim JH. Primary signet ring cell carcinoma of the uterine cervix: A case report. Medicine (Baltimore) 2021; 100:e26844. [PMID: 34397857 PMCID: PMC8341283 DOI: 10.1097/md.0000000000026844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/19/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Primary signet ring cell carcinoma of the uterine cervix is extremely rare and the clinical characteristics and prognosis are not well known and there are no specific guidelines for treatment. PATIENT CONCERNS A 43-year-old woman was referred to our hospital for abnormal uterine bleeding lasting 1 month. DIAGNOSES Histological examination revealed a signet ring cell carcinoma of the uterine cervix. After evaluation of extragenital origin, the patient was diagnosed International Federation of Gynecology and Obstetrics stage IIIC1 primary signet ring cell carcinoma or the uterine cervix. INTERVENTION The patient was prescribed concomitant chemo-radiation followed by intracavitary brachytherapy. OUTCOMES She showed no evidence of disease after treatment but, it recurred after 7 months of last treatment. LESSONS Different approaches to diagnosis and treatment of this rare disease are needed and molecular pathological studies related to the onset of the disease are required.
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Affiliation(s)
- Yeon Hee Kim
- Department of Obstetrics and Gynecology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyeonggi-do, Korea
| | - Su Jeong Lee
- Department of Obstetrics and Gynecology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyeonggi-do, Korea
| | - Seon Ui Lee
- Department of Obstetrics and Gynecology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyeonggi-do, Korea
| | - In Sun Hwang
- Department of Obstetrics and Gynecology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyeonggi-do, Korea
| | - Kwang Il Yim
- Department of Pathology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyeonggi-do, Korea
| | - Jin Hwi Kim
- Department of Obstetrics and Gynecology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyeonggi-do, Korea
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4
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Wang YC, Yu YL, Fan CW, Huang SY. Primary signet ring cell carcinoma of the cervix: A case report with review of the literature. Taiwan J Obstet Gynecol 2019; 57:862-866. [PMID: 30545542 DOI: 10.1016/j.tjog.2018.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2018] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE Primary cervical signet ring cell carcinoma (PCSRCC) is extremely rare. In this paper, we describe a case presenting with PCSRCC. CASE REPORT The 48-year-old woman visited the gynecological department because of postmenopausal bleeding. A cervical mass was discovered through pelvic examination, and the biopsy results indicated a poorly differentiated adenocarcinoma with a signet ring cell pattern. Colonoscopy revealed external compression of the rectum without intraluminal mucosal lesions. Abdominal computed tomography revealed a suspicious malignant lesion at the cervicorectal junction and multiple metastases. Debulking surgery was performed and the final pathology report documented a FIGO stage IVb PCSRCC involving multiple sites. CONCLUSION Complete tumor survey and staging are critical to differentiate primary from metastatic signet cell carcinoma of the cervix. Immunohistochemical studies cannot provide precise information. Because cases are rare, it is difficult to determine the proper treatment guidelines and prognosis.
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Affiliation(s)
- You-Chen Wang
- Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yen-Lin Yu
- Department of Colorectal Surgery, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chung-Wei Fan
- Department of Colorectal Surgery, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shih-Yin Huang
- Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
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Gadducci A, Guerrieri ME, Cosio S. Adenocarcinoma of the uterine cervix: Pathologic features, treatment options, clinical outcome and prognostic variables. Crit Rev Oncol Hematol 2019; 135:103-114. [PMID: 30819439 DOI: 10.1016/j.critrevonc.2019.01.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/16/2019] [Indexed: 12/11/2022] Open
Abstract
Adenocarcinoma accounts for 10-25% of all cervical cancers, and its relative and absolute rate has raised over the past decades. Most, but not all the authors, reported that adenocarcinoma has a greater propensity to lymph node, ovarian and distant metastases and a worse prognosis compared with squamous cell carcinoma. However, whether histologic type is an independent prognostic factor is still a debated issue. Moreover, adenocarcinoma is a very heterogenous disease, including different histological subtypes. Whereas radical hysterectomy and definitive radiotherapy achieve the same clinical outcome in early stage squamous cell carcinoma, surgery seems to obtain better survival compared with definitive radiotherapy in early stage adenocarcinoma. Chemoradiation is the standard treatment for locally advanced cervical cancer regardless of histologic type, although several retrospective studies showed that patients with adenocarcinoma were more likely to die than those with squamous cell carcinoma both before and after concurrent chemoradiation era. The prognostic relevance of biological variables, such as cyclin-dependent kinase inhibitors, p53, cyclooxygenase-2 [COX-2], cell surface tyrosine-kinases and programmed death-ligand [PD-L1], is still under investigation. Palliative chemotherapy is the only treatment option for persistent or recurrent cervical adenocarcinoma not amenable with surgery and radiotherapy. The use of immune checkpoint inhibitors as well as a therapeutic strategy targeting cell surface tyrosine kinases should be adequately explored in this clinical setting.
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Affiliation(s)
- Angiolo Gadducci
- Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Italy.
| | - Maria Elena Guerrieri
- Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Italy
| | - Stefania Cosio
- Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Italy
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Wang YC, Yu YL, Fan CW, Huang SY. Primary signet ring cell carcinoma of the cervix: A case report with review of the literature. Taiwan J Obstet Gynecol 2019; 58:46-50. [PMID: 30638479 DOI: 10.1016/j.tjog.2018.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Primary cervical signet ring cell carcinoma (PCSRCC) is extremely rare. In this paper, we describe a Case presenting with PCSRCC. CASE REPORT The 48-year-old woman visited the gynecological department because of postmenopausal bleeding. A cervical mass was discovered through pelvic examination, and the biopsy results indicated a poorly differentiated adenocarcinoma with a signet ring cell pattern. Colonoscopy revealed external compression of the rectum without intraluminal mucosal lesions. Abdominal computed tomography revealed a suspicious malignant lesion at the cervicorectal junction and multiple metastases. Debulking surgery was performed and the final pathology report documented a FIGO stage IVb PCSRCC involving multiple sites. CONCLUSION Complete tumor survey and staging are critical to differentiate primary from metastatic signet cell carcinoma of the cervix. Immunohistochemical studies cannot provide precise information. Because cases are rare, it is difficult to determine the proper treatment guidelines and prognosis.
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Affiliation(s)
- You-Chen Wang
- Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yen-Lin Yu
- Department of Colorectal Surgery, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chung-Wei Fan
- Department of Colorectal Surgery, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shih-Yin Huang
- Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
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Sal V, Kahramanoglu I, Turan H, Tokgozoglu N, Bese T, Aydin O, Demirkiran F, Arvas M. Primary signet ring cell carcinoma of the cervix: A case report and review of the literature. Int J Surg Case Rep 2016; 21:1-5. [PMID: 26874582 PMCID: PMC4802128 DOI: 10.1016/j.ijscr.2016.02.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 01/27/2016] [Accepted: 02/01/2016] [Indexed: 11/28/2022] Open
Abstract
To date, only 18 cases with primary signet cell carcinoma of the cervix has been reported. Differentiation of primary tumour from metastatic signet cell carcinoma carries significant important while treatment and prognosis differ significantly.
Introduction Primary signet cell carcinoma of the cervix has been reported only in 18 cases to date. Presentation of case A 48-year-old woman was seen at our Gynecologic Oncology Unit, because she complained postcoital bleeding during the last three months. She had 1–2 cm cervical mass, originating from the endocervical canal. A biopsy revealed a signet ring cell-type adenocarcinoma. Suspected primary sites were excluded after gastroscopy, colonoscopy and mammography. The patient underwent a laparoscopic type-3 radical hysterectomy with bilateral salpingo–oophorectomy, pelvic lymph node dissection and paraaortic lymph node dissection with a presumed diagnosis of primary signet ring cell carcinoma of the cervix. Microscopically, the tumour consisted of 70% signet ring cell type and 30% endocervical adenocarcinoma. She did not receive any adjuvant treatment. Follow-up at 18 months after surgery showed no evidence of recurrence. Discussion Nineteenth case of a primary signet ring cell carcinoma of the cervix was presented. Immunohistochemical studies and HPV DNA positivity may help in diagnosis. Conclusion It is crucial to differentiate primary tumour from metastatic signet cell carcinoma, while treatment and prognosis differ significantly.
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Affiliation(s)
- Veysel Sal
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cerrahpasa Medical Faculty, Istanbul University, Turkey
| | - Ilker Kahramanoglu
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cerrahpasa Medical Faculty, Istanbul University, Turkey.
| | - Hasan Turan
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cerrahpasa Medical Faculty, Istanbul University, Turkey
| | - Nedim Tokgozoglu
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cerrahpasa Medical Faculty, Istanbul University, Turkey
| | - Tugan Bese
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cerrahpasa Medical Faculty, Istanbul University, Turkey
| | - Ovgu Aydin
- Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University, Turkey
| | - Fuat Demirkiran
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cerrahpasa Medical Faculty, Istanbul University, Turkey
| | - Macit Arvas
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cerrahpasa Medical Faculty, Istanbul University, Turkey
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Cracchiolo B, Kuhn T, Heller D. Primary signet ring cell adenocarcinoma of the uterine cervix - A rare neoplasm that raises the question of metastasis to the cervix. Gynecol Oncol Rep 2016; 16:9-10. [PMID: 27331127 PMCID: PMC4899544 DOI: 10.1016/j.gore.2016.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 01/20/2016] [Accepted: 01/27/2016] [Indexed: 11/05/2022] Open
Abstract
Primary signet ring cell adenocarcinoma is extremely rare. Signet ring cell carcinoma is more commonly primary in the stomach or breast, and the more likely metastatic disease to the cervix needs to be ruled out. We present a case of primary signet ring cell carcinoma of the cervix and review the literature. Primary signet-ring cell carcinoma of the cervix is extremely rare. Primary signet-ring cell carcinoma appears to be aggressive in higher stage disease. Metastatic signet ring cell carcinoma needs to be ruled out.
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Affiliation(s)
- Bernadette Cracchiolo
- Department of Obstetrics, Gynecology, and Women's Health, Rutgers-New Jersey Medical School, Newark, NJ, United States
| | - Theresa Kuhn
- Department of Obstetrics, Gynecology, and Women's Health, Rutgers-New Jersey Medical School, Newark, NJ, United States
| | - Debra Heller
- Department of Obstetrics, Gynecology, and Women's Health, Rutgers-New Jersey Medical School, Newark, NJ, United States; Department of Pathology & Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, NJ, United States
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Loureiro J, Oliva E. The spectrum of cervical glandular neoplasia and issues in differential diagnosis. Arch Pathol Lab Med 2014; 138:453-83. [PMID: 24678677 DOI: 10.5858/arpa.2012-0493-ra] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Premalignant and malignant glandular lesions of the cervix are known to often cause diagnostic problems with a variety of benign (more common) as well as other malignant mimics, the latter setting often being represented by secondary involvement by endometrioid endometrial carcinoma especially in small samplings. OBJECTIVE To highlight key histologic features and immunohistochemical markers that may be helpful in the distinction of in situ endocervical carcinoma from benign glandular proliferations, and those that separate different subtypes of invasive endocervical carcinoma, as well as invasive carcinoma from other carcinomas secondarily involving the cervix and nonneoplastic proliferations of the cervix. CONCLUSIONS Clinical and morphologic features as well as immunohistochemistry results should be used in conjunction in the differential diagnosis of glandular proliferations of the cervix, as correct interpretation has major clinical consequences for the patient in most instances (especially benign versus malignant). Immunohistochemical markers should be used as part of a panel of antibodies, as exceptions may occur to the usual pattern of staining, and if used singly, they may mislead the pathologist to establish a wrong diagnosis.
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Affiliation(s)
- Joana Loureiro
- From the Department of Pathology, Instituto Português de Oncologia, Porto, Portugal (Dr Loureiro); and the Department of Pathology, Massachusetts General Hospital, Boston (Dr Oliva)
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Glassy cell carcinoma of the cervix: A systematic review and meta-analysis. Gynecol Oncol 2014; 133:186-91. [DOI: 10.1016/j.ygyno.2014.01.048] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/23/2014] [Accepted: 01/25/2014] [Indexed: 11/22/2022]
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A new case of primary signet-ring cell carcinoma of the cervix with prominent endometrial and myometrial involvement: Immunohistochemical and molecular studies and review of the literature. World J Surg Oncol 2012; 10:7. [PMID: 22236794 PMCID: PMC3320546 DOI: 10.1186/1477-7819-10-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 01/11/2012] [Indexed: 02/01/2023] Open
Abstract
Background As a rule, endocervical tumours with signet-ring cell are classed as metastatic extra-genital neoplasms. In a patient aged 45 years, we describe primary cervical signet-ring cell carcinoma (PCSRCC) characterized by prominent endometrial and myometrial involvement, simulating primary endometrial adenocarcinoma with cervical extension. In addition, a review was made of the literature to identify the clinical and pathological features of this rare malignancy. Case presentation A 45-year-old woman was referred to our Gynaecology Department due to persistent abnormal vaginal bleeding. Transvaginal ultrasonography showed slight endometrial irregularities in the whole uterine cavity suggestive of endometrial neoplasms. Pelvic magnetic resonance imaging revealed diffuse enlargement of the cervix, which had been replaced by a mass. Induration extended to the parametria and sigmoid colon fat. Histological examination of endometrial curettage and a cervical biopsy revealed a neoplasm characterized by neoplastic signet-ring cells and trabecular structures. Immunohistochemical analysis and molecular studies showed certain findings consistent with a cervical neoplasm, such as positivity to CEA, keratin 7, Ca-125 and p16 and the presence of HPV (Human Papilloma Virus) DNA 18. On examination of the hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy, the lesion replacing the cervix, endometrium and myometrium, revealed the same immunohistochemical findings observed on endometrial curettage and cervical biopsy specimens. Metastases were found in an ovarian cystic lesion and the lymph nodes. Conclusion With this report the authors have demonstrated that the spread of cervical adenocarcinoma to the uterine corpus, although rare, may be observed, and that in this instance immunohistochemical and molecular studies can provide sufficient information for accurate diagnosis even on small biopsy specimens.
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Primary signet-ring cell carcinoma of the cervix: case report and review of the literature. Int J Gynecol Pathol 2010; 29:181-4. [PMID: 20173504 DOI: 10.1097/pgp.0b013e3181b70176] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mucinous adenocarcinoma of the cervix has 5 subtypes: endocervical, intestinal, signet-ring cell, minimal deviation, and villoglandular. There are only rare reports of primary signet-ring cell carcinoma of the cervix in the literature. Herein we report a 53-year-old woman with cervical adenocarcinoma with signet-ring cell morphology. Thorough systemic examination did not reveal another primary focus. DNA extraction from paraffin-embedded tissue revealed the presence of human papilloma virus (HPV) type 18, which supports the cervical origin of the tumor. Signet-ring cell morphology can be observed in both benign and malignant lesions of the uterine cervix. Most of the malignant lesions are metastatic. Histological features and immunohistochemical profiles are discussed, and a review of signet-ring cell morphology in the uterine cervix is included.
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13
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Yamauchi N, Sameshima H, Osato K, Fukushima K, Sato Y, Ikenoue T. Carcinomatous meningitis from adenocarcinoma of the uterine cervix: A case report and literature review. J Obstet Gynaecol Res 2010; 36:444-7. [DOI: 10.1111/j.1447-0756.2009.01163.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Majeed U, Jamshed A, Hameed S, Shah MA, Anwar N, Ahmed Q, Mohsin F. Invasive carcinoma of uterine cervix in young females under 20 years. J OBSTET GYNAECOL 2009; 29:269-70. [DOI: 10.1080/01443610902734978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Suárez-Peñaranda JM, Abdulkader I, Barón-Duarte FJ, González Patiño E, Novo-Domínguez A, Varela-Durán J. Signet-ring Cell Carcinoma Presenting in the Uterine Cervix. Int J Gynecol Pathol 2007; 26:254-8. [PMID: 17581407 DOI: 10.1097/01.pgp.0000236949.49161.31] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Signet-ring cell carcinoma presenting in the uterine cervix is an uncommon neoplasm. It is usually a metastasis from a primary gastric tumor; only rarely, cervical involvement is the first manifestation of the disease. Primary signet-ring carcinoma of the cervix is extremely unusual, and it is always necessary to rule out a metastatic neoplasm. We report 3 cases of signet-ring cell carcinoma diagnosed in cervical biopsies. All cases were initially considered as metastatic, but a primary site other than the cervix could be confirmed in only 2 cases. Although autopsy was not authorized, a very comprehensive clinical workup and the evolution of the disease support the interpretation of the third case as a primary neoplasm. Primary signet-ring cell carcinoma of the cervix is an extraordinary event-the diagnosis of which requires excluding a metastasis from the gastrointestinal tract (usually the stomach), the ovary, or the breast.
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Ruiz-Hernández G, Delgado-Bolton RC, Rubio-Pérez MJ, Jiménez-Vicioso A, Pérez-Castejón MJ, Carreras-Delgado JL. Recurrencia de un carcinoma gástrico de células en anillo de sello demostrada por PET-FDG. ACTA ACUST UNITED AC 2005; 24:326-30. [PMID: 16194466 DOI: 10.1157/13079285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To present the case report of a patient with undifferentiated and diffuse signet-ring cell gastric carcinoma in which FDG-PET evidenced recurrent disease. MATERIALS AND METHODS The patient was diagnosed of a stage III gastric carcinoma in 1994 and was treated with a subtotal gastrectomy. In February 2003, recurrent disease was detected in mediastinal and left supraclavicular lymph nodes. The patient was treated with chemotherapy and radiotherapy, reaching a complete response. After 6 months free of disease, he presented an elevation of the tumor markers with negative results in conventional imaging methods (upper digestive endoscopy, bone scintigraphy, and CT). An FDG-PET scan was performed to rule out recurrent disease. RESULTS FDG-PET detected pathologic findings suggestive of malignant disease in right supraclavicular and mediastinal lymph nodes. These findings were confirmed by clinical follow-up and with another CT scan performed 4 months later. CONCLUSIONS In this case report we stress the importance of early recurrence by FDG-PET in a non-intestinal gastric carcinoma. This is of interest given the greater difficulty to detect mucous secreting and/or producing carcinomas with the PET-FDG.
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