A CASE OF SIGNET RING CELL CARCINOMA OCCURRING IN THE ILEUM

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  • 回腸原発ｓｉｇｎｅｔ　ｒｉｎｇ　ｃｅｌｌ　ｃａｒｃｉｎｏｍａの１例

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Abstract

We report an extremely rare case, in which a 45-year-old male was treated with a laparotomy on the basis of a diagnosis of Crohn's disease that was changed postoperatively to a definite diagnosis of signet ring cell carcinoma occurring primarily in the ileum. The man first visited a local doctor with abdominal pain and vomiting, who made a diagnosis of intestinal occlusion. The patient was referred to our clinic, since Crohn's disease was suspected based on results of a contrast study of the small intestine. We performed a laparotomy and found hardening of the wall and marked stenosis in the terminal ileum, which was removed by an ileocecal resection. A longitudinal ulcer was observed in the excised specimen, which suggested that Crohn's disease was most likely, whereas signet ring cell carcinoma was evident from the results of a histological examination. No other primary lesion was found in a postoperative whole-body examination. Although adjuvant chemotherapy was given, the patient suffered from peritoneal metastasis 2 years later and died 2 years 3 months after the operation. Establishment of proper operative procedures and a chemotherapy regimen is required, along with an accumulation of case studies.

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