Pulmonary Adenocarcinoma With Signet Ring Features: An Unusual Case of a Rare Disease

Kovacevic, Jason; Satishchandran, Abhishek; Weitzner, Zachary; Hasan, Shamis; Khan, Sabbir Ahmed; Sheridan, Todd; Dikengil, Fusun

doi:10.1016/j.chest.2017.08.713

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“…This is important as about 3%-7% of primary SRCA of the lung are found to be positive for ALK gene rearrangement [ 2 ]. Crizotinib, a small molecule tyrosine kinase inhibitor, was approved by the Food and Drug Administration in 2011 for the treatment of patients who tested positive for the ALK gene rearrangement [ 7 ]. Studies thereafter demonstrated its efficacy in patients with non-small cell lung carcinoma (NSCLC) who tested positive for the ALK gene rearrangement and ROS1 receptor tyrosine kinasegene mutation [ 6 , 8 ]; however, there is still not enough data to assess the efficacy of crizotinib in the population with primary SRCA of the lung who test positive for the ALK gene mutation [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Studies thereafter demonstrated its efficacy in patients with non-small cell lung carcinoma (NSCLC) who tested positive for the ALK gene rearrangement and ROS1 receptor tyrosine kinasegene mutation [ 6 , 8 ]; however, there is still not enough data to assess the efficacy of crizotinib in the population with primary SRCA of the lung who test positive for the ALK gene mutation [ 2 ]. Regardless, it is still recommended that patients diagnosed with SRCA undergo testing for rearrangements in ALK genes, as positivity broadens available treatment options [ 7 ]. Our patient tested negative for EGFR , ALK , and ROS1 gene mutation but positive for BRAF gene mutation, which has been demonstrated in 2%-4% of lung adenocarcinomas [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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Large Pleural Effusion Secondary to Primary Signet-Ring Cell Adenocarcinoma of the Lung

Baroud¹,

Moustafa²,

Ibrahim³

2021

Cureus

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Primary signet-ring cell adenocarcinomas (SRCA) that occur outside the gastrointestinal tract are rare with few cases reported in the literature. They carry a poor prognosis and can be a challenge to diagnose. In this case report, we present the case of a 69-year-old female who presented to our hospital with a large left-sided pleural effusion. The findings seen on histopathology and immunohistochemistry (IHC) staining of the pleural fluid were consistent with primary signet-ring cell adenocarcinoma of the lung, and further investigations excluded a secondary source of malignancy. To the best of our knowledge, this is the first reported case of pleural effusion without an underlying lung mass diagnosed as primary signet-ring cell adenocarcinoma of the lung. Given how rare primary signet-ring cell adenocarcinoma of the lung is, it is important for physicians to carry out a comprehensive diagnostic workup to differentiate between primary and metastatic signet-ring cell adenocarcinoma as this will determine prognosis and treatment.

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