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Review
. 2006 Jun 7;12(21):3446-9.
doi: 10.3748/wjg.v12.i21.3446.

Primary signet-ring cell carcinoma of the colon at early stage: a case report and a review of the literature

Kuang-I Fu  1 , Yasushi Sano, Shigeharu Kato, Hiroki Saito, Atsushi Ochiai, Takahiro Fujimori, Yutaka Saito, Takahisa Matsuda, Takahiro Fujii, Shigeaki Yoshida
Affiliations
Review

Primary signet-ring cell carcinoma of the colon at early stage: a case report and a review of the literature

Kuang-I Fu et al. World J Gastroenterol. .

Abstract

A 67-year-old man, who had undergone surgery to resect multiple gastric cancers 4 years ago, visited our hospital for surveillance colonoscopy. Colonoscopy revealed a discolored, 7-mm in diameter, flat-elevated lesion with central depression in the transverse colon near the splenic flexure. Although the findings of endoscopy and barium enema were suggestive of submucosal invasion, the patient chose to undergo endoscopic mucosal resection. Pathological examination of the resected specimen revealed signet-ring cell carcinoma and a positive surgical margin. A second operation was performed, and no residual tumor or metastasis to lymph nodes was found in the resected specimens. Primary colorectal cancers composed of signet-ring cell carcinoma detected and treated at an early stage are extremely rare. We present a case and review the literature.

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Figures

Figure 1
Figure 1
A: Colonoscopy revealed a discolored, flat-elevated lesion with central depression, 7 mm in diameter, in the transverse colon near the splenic flexure; B: Chromoendoscopy with 0.2% indigo-carmine dye showed the depressed area more clearly; C: Magnifying colonoscopy after 0.05% crystal violet staining was attempted but failed to detect the pit pattern for depth estimation, as the depressed area was covered by dense mucus, which could not be removed by repeated water washing.
Figure 2
Figure 2
A, B: Histologically, the resected specimen showed a signet-ring cell carcinoma that had deeply invaded into the submucosal layer, and the vertical cut end of the resected tumor was positive for carcinoma cells.
See this image and copyright information in PMC

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