Primary Signet-ring Cell Carcinoma of the Cervix: Case Report and Review of the Literature

Abstract

Mucinous adenocarcinoma of the cervix has 5 subtypes: endocervical, intestinal, signet-ring cell, minimal deviation, and villoglandular. There are only rare reports of primary signet-ring cell carcinoma of the cervix in the literature. Herein we report a 53-year-old woman with cervical adenocarcinoma with signet-ring cell morphology. Thorough systemic examination did not reveal another primary focus. DNA extraction from paraffin-embedded tissue revealed the presence of human papilloma virus (HPV) type 18, which supports the cervical origin of the tumor. Signet-ring cell morphology can be observed in both benign and malignant lesions of the uterine cervix. Most of the malignant lesions are metastatic. Histological features and immunohistochemical profiles are discussed, and a review of signet-ring cell morphology in the uterine cervix is included.

A New Case of Primary Signet Ring Cell Carcinoma of the Uterine Cervix: A Case Report and Review of the Literature

“…No positive case of PCSRCC was reported [5]. Oestrogen and progesterone receptors have been tested in only 4 previous cases [2,3,9] and these were present only in one example [10]. Neuroendocrine differentiations have been demonstrated in two cases [7,10] but these markers were negative in our case.…”

“…Adenocarcinomas with signet ring cell are mostly metastatic from gastric, breast, colonic or ovarian carcinomas and primary tumor is extremely rare [1][2][3]. The prognosis of primary signet-ring cell carcinoma (PSRCCs) of the cervix is not well known as a result of the small number of case reports.…”

“…Mucinous adenocarcinoma of the cervix was subdivided into 5 subtypes: endocervical, intestinal, signet-ring cell, minimal deviation, and villoglandular [2]. Adenocarcinomas with signet ring cell are mostly metastatic from gastric, breast, colonic or ovarian carcinomas and primary tumor is extremely rare [1][2][3].…”

Metástasis de carcinoma de células en anillo de sello al cuello uterino

“…Lo frecuente es el compromiso cervical silente o sintomático a partir de carcinomas distantes, sin embargo se han descrito algunos casos aislados en que solo se ha observado carcinoma en el cérvix (5,22,23). Desde el punto de vista clínico, la ausencia de neoplasia extrauterina luego de un estudio sistémico cuidadoso y la mejor sobrevida, apoyan a que se trate de un carcinoma primario (5,22).…”

“…La presencia de virus HPV ha sido estudiada en algunos casos de carcinoma de células en anillo del cuello uterino y podría apoyar el origen primario (16,23,32). La negatividad en nuestros tres casos apoya el origen metastásico, sin embargo se debe tener cautela ya que el virus HPV de alto riesgo también ha sido demostrado en carcinomas mamarios con una prevalencia media de un 23%, incluyendo variaciones geográficas y controversias sobre el rol en el desarrollo de la neoplasia (33)(34)(35).…”