Primary Endometrial Adenocarcinoma with Signet-Ring Cells: A Rarely Observed Case and Review of the Literature

Abstract

An extremely rare case of a “primary endometrial adenocarcinoma with signet-ring cells” is presented in this study with microscopical images of the characteristic coexistence of the tumour and intermediate precancerous areas containing signet-ring cells.

Endometrium-Limited Metastasis of Extragenital Malignancies: A Challenge in the Diagnosis of Endometrial Curettage Specimens

“…In cases where the signet ring cells are accompanied by an endometrioid carcinoma component, the tumor may be diagnosed as an endometrioid carcinoma with signet ring cells [49]. Primary endometrial signet ring cell carcinoma, in which the entire or majority of tumor tissue consists of signet ring cells, is even rarer, and only two cases have been reported [49,50]. In cases where signet ring cell components are identified in endometrial tumors, metastases from extragenital organs should be initially considered.…”

“…In cases where signet ring cell components are identified in endometrial tumors, metastases from extragenital organs should be initially considered. The absence of precursor lesions, diffuse myometrial infiltration, and extensive lymphovascular invasion are suggestive of metastatic tumors [49,50]. Immunostaining may be helpful in differentiating between primary endometrial and metastatic tumors, particularly in cases where tumor cells demonstrate signet ring cell-like morphology.…”

Primary endometrial carcinoma with signet-ring cells. A case report and review of the literature

“…The diagnosis of this type of adenocarcinoma is one of exclusion, as in the presence of signet-ring cells in an endometrial tumor, the first diagnosis to rule out is a metastasis of a primary carcinoma of another origin, mainly from the gastrointestinal tract or the breast. For this reason, it is essential to carry out a thorough evaluation to include mammography, gastroscopy, colonoscopy and thoracoabdominopelvic CT [1].…”

“…Endometrial adenocarcinoma with signet-ring cells is a type of carcinoma that owes its peculiar appearance to the presence of a large mucin-filled vacuole within its cells that displaces the nucleus to the periphery [1]. When this infrequent histological subtype appears in the endometrium, it usually corresponds to a metastasis of a primary carcinoma of another origin, mainly from the gastrointestinal tract or the breast [1].…”

“…The World Health Organization Classification of tumors considers signet-ring cell carcinoma as a rare histological variant of cervical carcinoma of the uterus, although it does not include it among the histological variants of endometrial carcinoma [2]. To date, only six cases of primary endometrial carcinoma with signet-ring cells have been published in the English literature [1,[3][4][5][6].…”