A case of primary signet ring cell carcinoma of the rectum

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  • NUMAGA Yuki
    Department of Surgery, Fujiyoshida Municipal Hospital Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
  • ISHIKAWA Hitoshi
    Department of Surgery, Fujiyoshida Municipal Hospital
  • KOBAYASHI Junya
    Department of Surgery, Fujiyoshida Municipal Hospital
  • HONDA Yuji
    Department of Surgery, Fujiyoshida Municipal Hospital
  • SUNOSE Yutaka
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
  • TAKEYOSHI Izumi
    Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine

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Other Title
  • 直腸印環細胞癌の1例
  • 症例 直腸印環細胞癌の1例
  • ショウレイ チョクチョウインカン サイボウガン ノ 1レイ

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Abstract

Signet ring cell adenocarcinoma of the rectum is a comparatively rare disease with a poor prognosis. A 70-year-old man visited a medical clinic complaining of diarrhea and was referred to our hospital because of rectal stenosis detected on a barium enema. Blood examination, including that for tumor markers, yielded normal results. A barium enema showed a signature apple-core lesion in the Rb domain. Colonoscopy showed a circular, stricture-causing tumor approximately 5 cm from the anal verge. Abdominal CT showed circular, stricture-causing lesions in the rectum, but no lymph node or remote metastasis. Endoscopic biopsy specimens showed no malignancy. Based on these findings, a diagnosis of rectal cancer was made and low anterior resection was performed. Macroscopically, the rectal tumor was type 3 with respect to RaRb, with marked invasion to the depths. Histologically, the tumor was a signet ring cell carcinoma, INF-γ, intermediate type, se+a2, ly3, v2, ow-, aw-, ew-, n2(+). The patient received adjuvant chemotherapy, but died of carcinomatous peritonitis 3 years after surgery.

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