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

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

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*

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

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

BACKGROUND/AIMS: A primary signet ring cell carcinoma (SRCC) in the colorectum is unusual. This study evaluated the clinical and colonoscopic characteristics of primary colorectal SRCC. METHODS: Twenty-eight patients diagnosed with a primary colorectal SRCC and 100 patients diagnosed with a primary colorectal nonmucinous adenocarcinoma were enrolled in this study. The medical records and colonoscopic findings were reviewed. RESULTS: The mean age was younger in the SRCC patients than in the nonmucinous adenocarcinoma patients (47.3+/-15.5 years vs. 60.3+/-10.4 years, p<0.001). In SRCC, hematochezia was less frequent while abdominal pain was more common (p<0.001). Duke stages A or B was rare in SRCC (4/28, 14.3% vs. 58/100, 58.0%, p<0.001). The colonoscopic features of Borrmann type 4 was more common in SRCC (10/28, 35.7% vs. 3/100, 3.0%, p<0.001). The occurrence of a tumor in the right colon was more frequent in SRCC (17/28, 60.7% vs. 20/100, 20.0%, p<0.001). The diagnostic yield of the first colonoscopic biopsy was lower in the SRCC patients (85.7% vs. 98.0%, p=0.021). CONCLUSIONS: Primary colorectal SRCC appears to occur in younger patients compared with nonmucinous adenocarcinoma. A more advanced stage and an infiltrative lesion such as Borrmann type 4 appears to be common and the diagnostic yield of a colonoscopic biopsy tends to be low in primary colorectal SRCC.
Abdominal Pain ; Adenocarcinoma ; Biopsy ; Carcinoma, Signet Ring Cell* ; Colon ; Colonoscopy ; Gastrointestinal Hemorrhage ; Humans ; Medical Records

BACKGROUND/AIMS: To assess the therapeutic outcomes of endoscopic resection (ER) of early gastric cancer (EGC) with undifferentiated-type histology. METHODS: Cases of ER of EGC with undifferentiated-type histology in the Korean endoscopic submucosal dissection (ESD) registry database were identified and reviewed. The immediate outcomes, including en bloc resection, complete resection, and curative resection rates, and long-term outcomes, including recurrence and survival rates, were extracted and analyzed. RESULTS: From 2006 to 2015, 275 EGCs with undifferentiated-type histology from 275 patients were identified. The immediate outcomes were as follows: en bloc resection rate: 92.4%; complete resection rate: 80%; and curative resection rate: 36.4%. Compared to patients with lesions that were beyond the expanded indication, those with expanded indication lesions showed better therapeutic outcomes. There was no difference in immediate outcomes between patients with poorly differentiated adenocarcinoma (PDC) and signet ring cell carcinoma (SRC). However, compared to ER of SRC, ER of PDC had a stronger association with submucosal invasion (41.9% vs. 23.6%, p=0.003). With regard to long-term outcomes, there was no difference between lesions with curative and non-curative resections in the recurrence and mortality rates. These rates also did not differ between PDC and SRC (median follow up: 3.96 years). CONCLUSIONS: ER confined to expanded indication lesions can be considered for treatment of EGC with undifferentiated-type histology.
Adenocarcinoma ; Carcinoma, Signet Ring Cell ; Follow-Up Studies ; Humans ; Mortality ; Recurrence ; Stomach Neoplasms* ; Survival Rate

A hematogenous or lymphogenous metastasis and a direct or disseminated invasion can occur in cases of a gastrointestinal metastasis. Moreover, a hepatic or peritoneal metastasis is common in advanced gastric cancer. However, a colonic metastasis, particularly an appendicular metastasis, is quite rare. Recently, we experienced a case with an appendicular submucosal tumor-like elevated lesion and multiple rectal elevated lesions during a colonoscopy in an advanced gastric cancer patient. The appendicular lesion was resected endoscopically and a biopsy of the rectal lesions was performed. The pathologic diagnosis was an appendicular and rectal metastasis of a signet ring cell carcinoma. We describe a case of appendicular and rectal metastasis from gastric cancer. The results highlight the importance of considering a metastatic carcinoma when an appendicular or rectal mass is found incidentally in a malignant neoplasm patient.
Biopsy ; Carcinoma, Signet Ring Cell ; Colon ; Colonoscopy ; Diagnosis ; Humans ; Neoplasm Metastasis* ; Stomach Neoplasms*

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