Signet-ring Cell Carcinoma Derived from a Main Duct-type Intraductal Papillary Mucinous Neoplasm of the Pancreas: A Case Report with Long-term Follow-up

Sakai, Toshitaka; Koshita, Shinsuke; Ito, Kei; Kanno, Yoshihide; Ogawa, Takahisa; Kusunose, Hiroaki; Masu, Kaori; Kawakami, Yoshiyuki; Fujii, Yuki; Murabayashi, Touji; Hasegawa, Sho; Kozakai, Fumisato; Noda, Yutaka; Oikawa, Masaya; Tsuchiya, Takashi; Sawai, Takashi

doi:10.2169/internalmedicine.9743-17

Cited by 9 publications

(6 citation statements)

References 21 publications

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“…According to the study using the Surveillance, Epidemiology, and End Results database from 2000 to 2014, the incidence of pancreatic SRCC is 0.4-0.5% among all cases of pancreatic carcinoma [1]. Among the eight cases reported thus far (Table 1) [4][5][6][7][8][9][10][11], surgical treatment with radical resection, pancreatoduodenectomy, and/or total pancreatomy could be performed in four cases, and there was only one case of borderline-resectable tumor treated with neoadjuvant chemotherapy with gemcitabine.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Survival by Resection and Adjuvant Chemotherapy With S-1 in Pancreatic Signet Ring Cell Carcinoma: a Case Report With Literature Review

Takagi

Tokuda

Tanaka

et al. 2020

Preprint

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Background: Signet ring cell carcinoma (SRCC) of the pancreas is a very rare histologic variant of pancreatic carcinoma with very poor prognosis. We present a case of pancreatic SRCC with good prognosis achieved by resection and adjuvant chemotherapy with S-1 one year, which is the standard treatment for advanced resected gastric cancer in Japan. The stomach carried a higher incidence of SRCC than other sites.Case presentation: A 70-year-old man presented with abdominal discomfort, and ultrasonography revealed a mass in the pancreas. Computed tomography showed a hypovascular tumor in the head of the pancreas, 51 mm in diameter, with invasion to the portal vein and duodenum. The patient underwent pancreaticoduodenectomy (PD) with portal vein resection and reconstruction. The pathological diagnosis was SRCC of the pancreas without invasion to the portal vein, pT3N1M0 Stage IIB (UICC classification). Subsequently, postoperative adjuvant chemotherapy with S-1 was initiated to prevent recurrence. The patient has remained recurrence-free for 2 years and 6 months after PD. Conclusion: Adjuvant chemotherapy with S-1 may be an important factor for improving the prognosis of patients with resectable SRCC of the pancreas.

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Section: Discussionmentioning

confidence: 99%

Long-Term Survival by Resection and Adjuvant Chemotherapy With S-1 in Pancreatic Signet Ring Cell Carcinoma: a Case Report With Literature Review

Takagi

Tokuda

Tanaka

et al. 2020

Preprint

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“…From available case reports in the literature, the age at diagnosis of pancreatic SRCC ranged from 61 to 88 years. Mausam Patel et al, in their population‐based study, reported the mean age to be 66.6 years.…”

Section: Discussionmentioning

confidence: 99%

“…Case reports describe findings on CT which range from showing no significant changesto identification of a diffuse tissue mass involving the pancreas . Sakai T. et al reported a case of pancreatic SRCC detected as main pancreatic duct dilation, found primarily in the pancreatic body, with multiple mural nodules identified on CT scan …”

Section: Discussionmentioning

confidence: 99%

Primary signet ring cell carcinoma of the pancreatic head: A case report

Alexander

Rashid

Hollis

et al. 2019

Clinical Case Reports

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“…Currently, 12 case reports have been published in the English literature concerning primary SRCC of the pancreas. [5][6][7][8][9][10][11][12][13][14][15][16] Previously, Patel et al searched 497 pancreatic SRCC patients diagnosed between January 1, 1973, and December 31, 2013, SEER database and focused on determining the predictive effects of epidemiological factors and treatment interventions, with 1-, 2-, and 5-year overall survival (OS) rates of 17%, 9%, and 4%, respectively, which demonstrated very poor survival. [17] And Wu et al [18] identified 24,171 SRCC patients of different tumor locations from the SEER database and 441 pancreatic SRCC accounts for just 1.8%.…”

Section: Introductionmentioning

confidence: 99%

The value of the lymph node ratio and total number of lymph nodes examined for resected pancreatic signet ring cell carcinoma: a retrospective cohort study

Ren

Xue²,

et al. 2022

Journal of Pancreatology

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Background: Pancreatic signet ring cell carcinoma (SRCC) is an exceedingly rare histological subtype of pancreatic cancer. Previous studies have focused on the trends of incidence and independent predictors of pancreatic SRCC. Our objectives of the study were to analyze the prognostic value of the lymph node ratio (LNR) and to explore the minimal number of lymph nodes examined to accurately evaluate the N stage in resected pancreatic SRCC. Method: We analyzed 120 patients diagnosed from January 1, 1990, to December 31, 2016, constituted the study cohort from the Surveillance, Epidemiology, and End Results (SEER) registry. We calculated the overall survival (OS) of these patients by using a Kaplan–Meier analysis. The Kaplan–Meier analysis was used to analyze the influence of various factors on the prognosis of patients in the univariate analysis. The multivariate Cox analysis were applied to find independent prognostic factors of patients with pancreatic SRCC. Receiver-operating characteristic curve (ROC) analysis to investigate the discriminatory ability of the total number of lymph nodes examined (TNLE) relative to whether lymph node metastasis was present. Results: The median number of lymph nodes examined among 120 patients with resected pancreatic SRCC was 14 (interquartile range: 6.25–20.0). According to the univariate analysis of OS, age, grade, chemotherapy, LNR, and TNLE were significantly different (P < .05). We demonstrated the prognostic benefit of chemotherapy in resected pancreatic SRCC, whereas radiotherapy was not associated with improved survival. The multivariate survival analysis showed that LNR and grade were independent prognostic indicators after pancreatic SRCC resection for OS. TNLE ≥ 8 showed the highest discriminatory power for evaluating lymph node metastasis (Area under curve (AUC): 0.656, 95% confidence interval: 0.564–0.741, Youden index:0.2533, sensitivity: 78.67%, specificity: 46.67%, P = .003). Conclusion: Our study indicated that the LNR was a valuable independent prognostic factor for resected pancreatic SRCC. Regional lymphadenectomy of at least 8 lymph nodes was necessary to accurately stage patients. An adequate number of lymph nodes examined are necessary for clinicians to accurately predict the significance of the LNR in resected pancreatic SRCC.

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Signet-ring Cell Carcinoma Derived from a Main Duct-type Intraductal Papillary Mucinous Neoplasm of the Pancreas: A Case Report with Long-term Follow-up

Cited by 9 publications

References 21 publications

Long-Term Survival by Resection and Adjuvant Chemotherapy With S-1 in Pancreatic Signet Ring Cell Carcinoma: a Case Report With Literature Review

Long-Term Survival by Resection and Adjuvant Chemotherapy With S-1 in Pancreatic Signet Ring Cell Carcinoma: a Case Report With Literature Review

Primary signet ring cell carcinoma of the pancreatic head: A case report

The value of the lymph node ratio and total number of lymph nodes examined for resected pancreatic signet ring cell carcinoma: a retrospective cohort study

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