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Sakalauskaite M, Garnelyte A, Civilka I, Dulskas A, Kincius M, Patasius A. Prostate Adenocarcinoma with Signet-Ring Cells and Features of Mucin: A Clinical Case and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:877. [PMID: 38929494 PMCID: PMC11205309 DOI: 10.3390/medicina60060877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
Introduction: Signet-ring cells are typically associated with mucin-secreting epithelium; thus, they are most commonly found in the gastrointestinal tract, but not exclusively. Primary signet-ring cell carcinoma of the prostate is a rare and poorly differentiated, aggressive acinar adenocarcinoma variant with a grim prognosis. Clinical Case: In June of 2023, a 54-year-old Caucasian male presented with a complaint of lower urinary tract obstructive symptoms with occasional macrohematuria, non-specific body aches, and shortness of breath. A prostate specimen obtained in transurethral resection of the prostate was sent for histopathological examination. After a series of extraprostatic diagnostic workups, including fibrogastroduodenoscopy, colonoscopy computed tomography imaging, and immunohistochemical studies, the patient was diagnosed with primary prostatic signet-ring cell adenocarcinoma stage IV. Unfortunately, due to the advanced stage of the disease, PE, and third-degree thrombocytopenia, the patient was not a candidate for chemotherapy and died of cardiopulmonary insufficiency later that week. Discussion: Prostatic signet-ring cell carcinoma accounts for 0.02% of all prostate adenocarcinoma cases. Due to its nature and epidemiology, a diligent extraprostatic investigation has to be carried out. The disease often presents with unremarkable clinical symptoms and variable serum prostate-specific antigen results, which may contribute to its late diagnosis. Inconsistent immunohistochemical findings and an unpredictable response to hormonal treatment together pose both diagnostic and therapeutic challenges that negatively affect the prognosis. Conclusions: This study highlights the importance of a multidisciplinary approach and the need for diagnostic and therapeutic consensus within the research community in search of the primary site of the disease, which may positively influence the prognosis.
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Affiliation(s)
- Migle Sakalauskaite
- Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
- Department of Oncourology, National Cancer Institute, 08406 Vilnius, Lithuania; (M.K.); (A.P.)
| | - Ausra Garnelyte
- National Center of Pathology, Vilnius University Hospital Santaros Clinics, 08661 Vilnius, Lithuania;
| | - Ignas Civilka
- Department of Abdominal and General Surgery and Oncology, National Cancer Institute, 08406 Vilnius, Lithuania; (I.C.); (A.D.)
| | - Audrius Dulskas
- Department of Abdominal and General Surgery and Oncology, National Cancer Institute, 08406 Vilnius, Lithuania; (I.C.); (A.D.)
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania
| | - Marius Kincius
- Department of Oncourology, National Cancer Institute, 08406 Vilnius, Lithuania; (M.K.); (A.P.)
| | - Ausvydas Patasius
- Department of Oncourology, National Cancer Institute, 08406 Vilnius, Lithuania; (M.K.); (A.P.)
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania
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Martinelli G, Stanca S, Bosco F, Zini L, De Masi F, Alì G. Massive lymphatic embolism in gallbladder signet ring cell carcinoma: An autopsy finding. Clin Res Hepatol Gastroenterol 2024; 48:102330. [PMID: 38552735 DOI: 10.1016/j.clinre.2024.102330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 03/23/2024] [Accepted: 03/27/2024] [Indexed: 04/08/2024]
Affiliation(s)
- Giulia Martinelli
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Stefano Stanca
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Francesca Bosco
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Leonardo Zini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, 56126 Pisa, Italy
| | - Francesco De Masi
- Neuroanesthesiology Section, University Hospital of Pisa, 56126 Pisa, Italy
| | - Greta Alì
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy.
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Hao Z, Deng Y, He Y, Xiong X. Signet-Ring Cutaneous Metastasis Presenting with Huge Bunches of Grapes. Clin Cosmet Investig Dermatol 2022; 15:1997-2001. [PMID: 36172248 PMCID: PMC9512062 DOI: 10.2147/ccid.s378478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022]
Abstract
Signet-ring cell (SRC) is a histologic type in which cells show unique features under the microscope. We mainly found signet-ring cells (SRCs) in gastrointestinal and breast tumors. Cutaneous metastasis from internal carcinomas was an uncommon presentation. The cases of signet-ring cell carcinoma (SRCC) metastasis to the skin were rarely reported. Cutaneous metastasis indicated a poor prognosis for a patient. Here, we report a female who had huge grape-like nodules arising from gastrointestinal SRCC in her trunk and thigh.
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Affiliation(s)
- Zhenyu Hao
- Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Yongqiong Deng
- Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Yuanmin He
- Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Xia Xiong
- Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
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Bagaporo Larrazabal R, Cheng PVC, David-Wang A, Requiso D. Signet-ring cell adenocarcinoma of unknown primary presenting with superior vena cava (SVC) syndrome: rare type of cancer. BMJ Case Rep 2019; 12:e232269. [PMID: 31888899 PMCID: PMC6936546 DOI: 10.1136/bcr-2019-232269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2019] [Indexed: 12/03/2022] Open
Abstract
A 53-year-old man presented with a 3-month history of progressive, non-productive cough followed by occasional swelling of the face and upper extremities. Physical examination on admission revealed prominent superficial vessels at the neck and upper extremity swelling. Bronchoscopy revealed the superior segment of the right lower lobe was narrow but without visible mass; cell block and biopsy done revealed signet-ring cell carcinoma with an immunohistochemistry pattern favouring the primary site of malignancy as either gastric or of the pancreaticobiliary tree. However, CT scan of the abdomen and pelvis with triple contrast revealed only slight gastric wall thickening; the pancreas was unremarkable. The patient underwent radiotherapy with noted improvement of symptoms. He was then discharged with plans for further work-up on an outpatient basis. This work highlights the importance of a comprehensive histopathological and immunohistochemical work-up which can help predict a site of origin to be able to provide the appropriate management.
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Affiliation(s)
- Ramon Bagaporo Larrazabal
- Department of Medicine, College of Medicine & Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Paula Victoria Catherine Cheng
- Department of Medicine, College of Medicine & Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Aileen David-Wang
- Division of Pulmonary Medicine, Department of Medicine & Philippine General Hospital, College of Medicine, University of the Philippines Manila, Manila, Metro Manila, Philippines
| | - Daryl Requiso
- Department of Laboratories, College of Medicine & Philippine General Hospital, University of the Philippines Manila, Manila, Metro Manila, Philippines
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Shi T, Huang M, Han D, Tang X, Chen Y, Li Z, Liu C, Xiang D, Wang T, Chen Y, Wang R, Lei Z, Chu X. Chemotherapy is associated with increased survival from colorectal signet ring cell carcinoma with distant metastasis: A Surveillance, Epidemiology, and End Results database analysis. Cancer Med 2019; 8:1930-1940. [PMID: 30864303 PMCID: PMC6488115 DOI: 10.1002/cam4.2054] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 02/07/2019] [Accepted: 02/08/2019] [Indexed: 12/13/2022] Open
Abstract
Background Colorectal signet ring cell carcinoma (SRCC) is a rare histological subtype of colorectal adenocarcinoma with high metastatic frequency compared to non‐SRCC colorectal cancer (NOS). The aim of this study was to analyze prognostic factors of colorectal SRCC with different metastatic sites and evaluate impacts of various therapies for metastatic colorectal SRCC. Methods Patients with NOS and SRCC were from the Surveillance, Epidemiology, and End Results (SEER) database during 2010‐2014. χ2 tests were used to compare data significance. Kaplan‐Meier and COX models were used to analyze the differences in the survival. Propensity‐matched analyses were used to adjust numerical differences. Results Among the 173 460 patients, 1932 (1.11%) patients had colorectal SRCC. In univariate analysis, older age, male sex, and peritoneum metastasis were associated with higher mortality risk. The peritoneum was both the site with the highest metastatic frequency and the site with the worst prognosis in SRCC. In the COX regression model, peritoneum‐metastatic SRCC patients receiving chemotherapy had better survival than patients treated with surgery. Conclusions Our study analyzed the unique metastatic pattern of colorectal SRCC toward different sites and found that compared to surgery, chemotherapy was associated with better survival for colorectal SRCC patients with distant metastasis, which provided insights for future SRCC patient treatment.
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Affiliation(s)
- Tao Shi
- Department of Medical Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, People's Republic of China
| | - Mengxi Huang
- Department of Medical Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, People's Republic of China
| | - Dong Han
- Department of Medical Oncology, Jinling Hospital, Nanjing Clinical School of Southern Medical University, Nanjing, Jiangsu Province, People's Republic of China
| | - Xinyi Tang
- Department of Medical Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, People's Republic of China
| | - Yanyan Chen
- Department of Medical Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, People's Republic of China
| | - Zhiping Li
- Department of Medical Oncology, Jinling Hospital, Nanjing Clinical School of Southern Medical University, Nanjing, Jiangsu Province, People's Republic of China
| | - Chao Liu
- Department of Medical Oncology, Jinling Hospital, Nanjing Clinical School of Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China
| | - Dan Xiang
- Department of Medical Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, People's Republic of China
| | - Ting Wang
- Department of Medical Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, People's Republic of China
| | - Yitian Chen
- Department of Medical Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, People's Republic of China
| | - Rui Wang
- Department of Medical Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, People's Republic of China
| | - Zengjie Lei
- Department of Medical Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, People's Republic of China.,Department of Medical Oncology, Jinling Hospital, Nanjing Clinical School of Southern Medical University, Nanjing, Jiangsu Province, People's Republic of China
| | - Xiaoyuan Chu
- Department of Medical Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, People's Republic of China.,Department of Medical Oncology, Jinling Hospital, Nanjing Clinical School of Southern Medical University, Nanjing, Jiangsu Province, People's Republic of China
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Handa H, Gomi D, Fukushima T, Kobayashi T, Sekiguchi N, Sakamoto A, Tsukahara Y, Matsushita H, Sasaki S, Mamiya K, Koizumi T, Ichiyama T. Signet Ring Cell Carcinoma of Unknown Primary Origin Detected Incidentally by Lymph Node Purification for Thyroid Carcinoma. Intern Med 2018; 57:31-35. [PMID: 29033443 PMCID: PMC5799053 DOI: 10.2169/internalmedicine.9234-17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 63-year-old woman underwent thyroidectomy for papillary thyroid adenocarcinoma and cervical lymph node resection. Pathological analyses revealed the presence of signet cell carcinoma in a resected lymph node, which were apparently different from the pathological findings of thyroid carcinoma. No evidence of a primary tumor could be found elsewhere despite detailed examinations, including esophagogastroduodenoscopy, colonoscopy, capsule endoscopy, CT scan, and fluorodeoxyglucose-positron emission tomography. Two and half years later, the patient developed multiple bone metastases and the pathological findings confirmed the presence of signet cell carcinoma. The primary origin remained undetermined. Metastatic signet ring cell carcinoma of unknown primary origin is extremely rare.
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Affiliation(s)
- Hideo Handa
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
| | - Daisuke Gomi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
| | - Toshirou Fukushima
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
| | - Takashi Kobayashi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
| | - Nodoka Sekiguchi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
| | - Akiyuki Sakamoto
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Japan
| | - Yoshiko Tsukahara
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Japan
| | - Hirohide Matsushita
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
| | - Shigeru Sasaki
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
| | - Keiko Mamiya
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
| | - Tomonobu Koizumi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
| | - Takashi Ichiyama
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
- First Department of Internal Medicine, Shinshu University School of Medicine, Japan
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Al-Taee A, Almukhtar R, Lai J, Jallad B. Metastatic signet ring cell carcinoma of unknown primary origin: a case report and review of the literature. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:283. [PMID: 27570777 DOI: 10.21037/atm.2016.07.24] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In spite of the increasingly sophisticated diagnostic workup, detailed investigations fail to reveal a primary site of origin for about 3-5% of metastatic tumors. The most commonly reported subtype in cancer of unknown primary origin is adenocarcinoma. Signet ring cell carcinoma (SRCC) is a rare poorly differentiated aggressive subtype of adenocarcinoma that most commonly arise from the gastrointestinal tract. It usually presents late and is associated with poor prognosis. Treatment options remain limited to anecdotal reports. However, immunohistochemical studies can be useful in suggesting an origin and therefore may help guide investigations and treatment options. Here we present an unusual case of metastatic SRCC of unknown primary origin presenting as peritoneal carcinomatosis in a 73-year-old man. We also review the literature on metastatic SRCC of unknown primary origin and discuss the relevant findings. This work highlights the importance of collaboration between clinicians and pathologists as well as detailed histopathological, immunohistochemical, and molecular analyses which can help guide investigations and management options.
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Affiliation(s)
- Ahmad Al-Taee
- Department of Internal Medicine, Saint Louis University Cancer Center, St. Louis, MO 63110, USA
| | - Rawaa Almukhtar
- Department of Internal Medicine, Saint Louis University Cancer Center, St. Louis, MO 63110, USA
| | - Jinping Lai
- Department of Pathology, Saint Louis University Cancer Center, St. Louis, MO 63110, USA
| | - Bassel Jallad
- Division of Hematology and Oncology, Saint Louis University Cancer Center, St. Louis, MO 63110, USA
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