Signet ring cell adenocarcinomas may be encountered in various parts of gastrointestinal tract but are almost unheard of in the region of ampulla of vater. In the region of ampulla of vater even if we come across an adenocarcinoma, it is usually a well differentiated variant. A 56-year-old female with features of obstructive jaundice on evaluation was diagnosed to have a peri-ampullary carcinoma.The patient was subjected to a laparotomy. On exploration patient was found to have a malrotation of gut. Patient was subjected to a pylorus preserving pancreatico-duodenectomy. Histopathology of the resected specimen revealed a signet ring morphology which is a rare variant in periampullary region.
Adenocarcinoma ; Carcinoma, Signet Ring Cell

Gastric polyps can be categorized as hyperplastic or adenomatous. Hyperplastic gastric polyps account for 28~77% of gastric polyps. Adenomatous polyps are recommended for removal due to their premalignant potential. However, there is no consensus on treatment and endoscopic surveillance of hyperplastic gastric polyps. The incidence of malignant neoplasms found in hyperplastic polyps has been reported to be about 2.1%; most of the reported cases of hyperplastic gastric polyps with malignant transformation were histologically well differentiated. We report a rare case of a gastric hyperplastic polyp with a signet ring cell carcinoma, with a review of the literature.
Adenomatous Polyps ; Carcinoma, Signet Ring Cell ; Consensus ; Incidence ; Polyps

PURPOSE: Signet-ring cell carcinoma is rather invasive and infiltrative than other histologic types of gastric cancer. We evaluated the characteristic CT findings of signet-ring cell carcinoma especially in the intensity and pattern of contrast enhancement. MATERIALS AND METHODS: We analyzed the CT findings of 22 cases with histologically proven signet-ring cell carcinoma, and compared them with those of 35 cases with histologically proven tubular adenocarcinoma. RESULTS: The double ring enhancement of the gastric mass was seen in 12 cases of signet-ring cell carcinoma and only one case of tubular adenocarcinoma. The masses of signet-ring cell carcinoma were enhanced more by the CT number of 10.2 than those of tubular adenocarcinoma. Of the masses of signet-ring cell carcinoma, those showed double ring enhancement were more intensely enhanced than those showed diffuse enhancement by the CT number of 22.9. CONCLUSION: We thought that neovascularity and different infiltration of the tumor cells in the gastric wall were responsible for the intense enhancement and double ring sign of signet-ring cell carcinoma. The possiblity of signet-ring cell carcinoma is high if a gastric mass show double ring sign and strong contrast enhancement.
Adenocarcinoma ; Carcinoma, Signet Ring Cell* ; Stomach Neoplasms ; Stomach*

Juvenile polyps are relatively common polyps that affect predominantly young patients and may occur in isolated, multiple, and/or familial forms. They have been considered to be benign lesions without neoplastic potential, but for patients with multiple juvenile polyposis, the cumulative malignant risk is greater than fifty percents. In patients with a solitary polyp, the risks are minimal, and only a few cases of malignant change from a solitary juvenile polyp have been reported. We describe the case of a twenty one year old female with one solitary juvenile polyp, which contained a signet ring cell carcinoma in the mucosal layer.
Carcinoma, Signet Ring Cell ; Colon ; Colonic Polyps ; Female ; Humans ; Polyps

Signet ring cell carcinoma is a rare type of mucinous adenocarcinoma of the uterine cervix. To the best of our knowledge, there is no report on cytologic findings of primary signet ring cell carcinoma of the uterine cervix in the literature. Recently, we experienced two cases of signet ring cell carcinoma of the uterine cervix. The finding of characteristic signet ring cells on cervicovaginal smear led to the diagnosis of signet ring cell carcinoma. However, primary signet ring cell carcinoma could not be cytologically distinguished from more common metastatic tumor. Therefore, diagnosis rests upon the recognition of signet ring cells and the absence of signet ring cell carcinoma elsewhere.
Adenocarcinoma, Mucinous ; Carcinoma, Signet Ring Cell* ; Cervix Uteri* ; Diagnosis ; Female

Two Korean women (41 and 23-years of age) presented with painful breast enlargement and redness. The involved breast was confirmed as metastatic signet ring cell carcinoma. Although metastatic signet ring cell carcinoma of the breast shows similar clinical symptoms to inflammatory breast cancer, the difference between the two is that this malignancy showed no microcalcifications or mass on radiographic findings (mammograms and US). Therefore, after the confirmation of signet ring cell carcinoma of the breast has been made, metastatic signet ring cell carcinoma should be considered if there are no microcalcifications or masses evident on radiographic findings.
Adult ; Breast Neoplasms/secondary* ; Breast Neoplasms/radiography* ; Breast Neoplasms/pathology ; Carcinoma, Signet Ring Cell/secondary* ; Carcinoma, Signet Ring Cell/radiography* ; Carcinoma, Signet Ring Cell/radiography* ; Case Report ; Female ; Human ; Stomach Neoplasms/pathology* ; Tomography, X-Ray Computed ; Ultrasonography

We present herein the occurrence of multifocal adenocarcinomas with a minute signet ring cell carcinoma that arose within a gastric inverted hyperplastic polyp (IHP) in a 40-year-old woman. Endoscopic ultrasonography demonstrated a heterogeneous hypoechoic mass in the third layer of the gastric wall. The endoscopic submucosal dissection specimen measuring 3.5x3.2x1.8 cm was a well-circumscribed protruding lesion that had a slit-shaped cavity. Histologically, the lesion consisted mainly of endophytic proliferation of hyperplastic columnar cells resembling normal foveolar epithelium. In addition, six foci of adenocarcinomas and a minute focus of signet ring cell carcinoma were randomly distributed in the superficial and deep regions. The adenocarcinoma was gradually transitioning from dysplasia, while the signet ring cell carcinoma was surrounded by hyperplastic foveolar epithelium. This is the first report of a gastric IHP with multifocal intramucosal adenocarcinomas and a signet ring cell carcinoma, and endoscopic submucosal dissection is used to completely resect it.
Adenocarcinoma ; Adult ; Carcinoma, Signet Ring Cell ; Endosonography ; Epithelium ; Female ; Humans ; Polyps ; Stomach

An exceedingly rare case of perforated early gastric cancer is reported. A 68-year-old man developed peritonitis due to perforation of early gastric cancer. An emergency radical operation was performed and was followed by an uneventful recovery. Histologic examination of the surgical specimen showed type III early gastric cancer composed of a signet ring cell carcinoma. Five years after surgery, the patients was alive with no evidence of tumor recurrence. The rarity of this complication in early gastric cancer is discussed, and a review of the literature is presented.
Aged ; Carcinoma, Signet Ring Cell ; Emergencies ; Humans ; Peritonitis ; Recurrence ; Stomach Neoplasms*

PURPOSE: To investigate the clinical benefits of F18-fluorodeoxyglucose-positron emission tomography and computed tomography (18F-FDG-PET/CT) over multi-detector row CT (MDCT) in preoperative staging of gastric cancer. METHODS: FDG-PET/CT and MDCT were performed on 78 patients with gastric cancer pathologically diagnosed by endoscopy. The accuracy of radiologic staging retrospectively was compared to pathologic result after curative resection. RESULTS: Primary tumors were detected in 51 (65.4%) patients with 18F-FDG-PET/CT, and 47 (60.3%) patients with MDCT. Regarding detection of lymph node metastasis, the sensitivity of FDG-PET/CT was 51.5% with an accuracy of 71.8%, whereas those of MDCT were 69.7% and 69.2%, respectively. The sensitivity of 18F-FDG-PET/CT for a primary tumor with signet ring cell carcinoma was lower than that of 18F-FDG-PET/CT for a primary tumor with non-signet ring cell carcinoma (35.3% vs. 73.8%, P < 0.01). CONCLUSION: Due to its low sensitivity, 18F-FDG-PET/CT alone shows no definite clinical benefit for prediction of lymph node metastasis in preoperative staging of gastric cancer.
Carcinoma, Signet Ring Cell ; Endoscopy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Retrospective Studies ; Stomach Neoplasms

PURPOSE: When cancer cels invade the stroma, they should be dissociated from the adjacent cells at first. E-cadherin and beta-catenin constitute an important protein complex associated with cellular adhesion, development, and differentiation, especially in epithelial cells.The role of E-cadherin and beta- catenin in gastric carcinogenesis were studied. MATENRIALS AND METHODS: The expression of E-cadherin and beta-catenin in gastric adenocarcinomas by using immunohistochemical staining and the mutation by using polymerase chain reaction- single stranded conformation polymorphism (PCR-SSCP) and sequencing were performed in 40 adenocarcinomas and 5 dysplasia of stomach. Thirteen cases, which had lymph node metastasis, were also included for immunohistochemical staining. RESULTS: Inappropriate cytoplasmic and/or nuclear expression of a E-cadherin-beta-catenin complex was more frequent in poorly differentiated, diffuse type signet ring cell carcinomas than in well-differentiated, intestinal type adenocarcinomas (P<0.05). However, the expression was not related with clinical stage or lymph node metastasis. Mutation of E-cadherin was detected in 4 cases by using PCR-SSCP, whereas mutation of beta-catenin was detected in 2 cases. CONCLUSION: E-cadherin and beta-catenin seem to be important in gastric carcinogenesis, especially in poorly differentiated diffuse type.
Adenocarcinoma ; beta Catenin* ; Cadherins* ; Carcinogenesis ; Carcinoma, Signet Ring Cell ; Cytoplasm ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Stomach