Signet-ring cell carcinoma of the colon 7 mm in size with peritonitis carcinomatosa

Shimaoka, Shunji; Niihara, Tooru; Tashiro, Kotaro; Matsuda, Akio; Nioh, Tatsuyuki; Ohi, Hidehisa; Nishimata, Yoshito; Nishimata, Hiroto; Fujita, Hiroshi; Ohkura, Yasuo; Hamada, Minori
July 2002
Journal of Gastroenterology;2002, Vol. 37 Issue 7, p550
Academic Journal
A 72-year-old woman was admitted with a complaint of a sensation of abdominal fullness. Cytologic examination of ascites revealed many poorly differentiated adenocarcinoma cells. Barium enema study and colonoscopy revealed IIa+IIc-type carcinoma of the descending colon. Endoscopic mucosal resection was performed to determine the histological type and the depth of invasion. The resected tumor was 7 × 6 mm in size, and an amorphous pit pattern was observed in the depressed area by stereomicroscopy. Poorly differentiated adenocarcinoma with signet-ring cells had diffusely infiltrated into the deeper part of the submucosal layer. Immunohistochemical findings showed this tumor to have mucin derived from gastric foveolar epithelium, suggesting that the signet-ring cell carcinoma of the colon showed gastric differentiation. Primary signet-ring cell carcinoma of the colon and rectum is a rare form of adenocarcinoma of the large intestine and shows more malignant biological behavior than ordinary colorectal carcinoma. Early diagnosis and curative operation are important.


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