Primary Signet Ring Cell Carcinoma of the Urinary Bladder

Abstract

Primary signet ring cell carcinoma of the urinary bladder is a relatively rare histological variant of mucus-producing adenocarcinoma usually of poor prognosis. We report two cases of primary bladder signet ring carcinoma. The first patient underwent a radical cystectomy with ileal conduit (pT3bN1M0), radiotherapy, and chemotherapy (M-VAC regimen) and subsequently expired 37 months after surgery. The other was initially diagnosed with peritoneal metastasis from the primary bladder signet ring cell carcinoma and was treated with partial cystectomy (pT3bNOM1 Primary signet ring cell carcinoma of the urinary bladder is an extremely rare variant of adenocarcinoma that was first described by Saphir 1 in 1955. This tumor initially presents as a high-grade, high-stage lesion, because the neoplasm diffusely invades the bladder wall without forming intraluminal growth.As a result, patients have no specific symptoms, which leads to delayed diagnosis and poor prognosis. 2 We present 2 cases of primary signet ring cell carcinoma of the urinary bladder with a brief review of the current literature. CASE REPORTS CASE 1A 35-year-old man was admitted after experiencing painless gross hematuria for 3 months. The patient had no concomitant medical history or familial history of any malignancy. Laboratory data were within the normal ranges except for many red

Primary signet-ring cell carcinoma of the urinary bladder successfully managed with cisplatin and gemcitabine: a case report

“…Primary signet-ring cell carcinoma of the urinary bladder is a relatively rare subtype of adenocarcinoma and comprises only 0.24% to 2% of all primary epithelial urinary bladder tumors [2,3]. Less than 100 cases have been reported in the literature since the first two cases reported by Saphir in 1955 [1].…”

“…Signet-ring cells can also be found in adenocarcinomas of urachal origin. Several criteria for classifying a tumor as urachal in origin have been suggested [2]: 1) tumor in the bladder (dome), 2) a sharp demarcation between the tumor and the surface epithelium, and 3) exclusion of primary adenocarcinoma located elsewhere that spread secondarily to the bladder. The present case showed no sharp demarcations between the tumor and the surface epithelium.…”

Signet Ring Cell Carcinoma of the Bladder and Urachus

“…A case report of successful adjuvant therapy with cisplatin and fluorouracil has been described [15], which may suggest a positive role. However other cases have shown no clear evidence of benefit with other regimens used in urothelial malignancies [16]. Due to the small number of cases any firm conclusions regarding overall efficacy are difficult to make.…”

Thyroid Gland Abscess: Uncommon complication

“…Primary Signet ring-cell carcinoma (SRCC) of the urinary bladder is said to be a relatively uncommon subtype of adenocarcinoma which has stated been to comprise only of 0.5% to 2% of primary carcinomas of the urinary bladder [1]. Following the first case of primary signet-ring cell carcinoma of urinary bladder which had been reported in 1955 by Saphir, [2,3] sporadic cases, case series and studies on primary and metastatic signet-ring cell carcinomas of the urinary bladder have been reported in the global literature. But because of the rarity of primary and metastatic signet-ring cell carcinomas of the urinary bladder, it would be envisaged that majority of clinicians including general practitioners, urologists, and pathologists, as well as oncologists would not have encountered a case of the disease before and hence they might not be familiar with the diagnostic features, biological behaviour, management, and management outcome of the tumour.…”

“…But because of the rarity of primary and metastatic signet-ring cell carcinomas of the urinary bladder, it would be envisaged that majority of clinicians including general practitioners, urologists, and pathologists, as well as oncologists would not have encountered a case of the disease before and hence they might not be familiar with the diagnostic features, biological behaviour, management, and management outcome of the tumour. Primary signet-ring cell carcinoma of the urinary bladder does have similar histopathology examination characteristics as that of primary signet-ring cell carcinomas of the gastrointestinal tract, breast, lung, gall bladder, prostate gland, and other organs and hence further evaluations to ascertain the primary sites of these tumours have been stated to be mandatory [3]. Considering that signet-ring cell carcinoma of the urinary bladder, whether it is a primary or metastatic tumour is an uncommon tumour, it would important for clinicians to have an overview background knowledge of signet-ring cell carcinomas generally and then about signet-ring cell carcinomas of the urinary bladder in order to be up to date with the diagnosis and management of signet-ring cell carcinomas of the urinary bladder whether primary or metastatic.…”