Subscribe to RSS
DOI: 10.1055/s-2001-19634
Signet-ring Cell Carcinoma of unknown primary Location. Metastatic to lower back Musculature - Remission following FU/FA Chemotherapy
Siegelringzellkarzinom mit unbekanntem Primarius und Metastasierung in die untere Rückenmuskulatur - Remission nach FU/FA-ChemotherapiePublication History
19.3.2001
24.7.2001
Publication Date:
21 January 2002 (online)
Abstract
The detection of gastrointestinal signet-ring cell carcinoma by endoscopy can be a diagnostic challenge. The main clinical features include atypical metastasis and a poor prognosis.
We present a case of a metastasizing signet-ring cell carcinoma with unknown primary location arising in 71-year-old female. Following 6 cycles of a routine intravenous FU/FA chemotherapy, an almost complete remission could be observed. After 2 years of follow up, metastatic recurrence was detected to the lower back musculature.
This case report emphasizes the difficulties in diagnosing signet-ring cell carcinoma by endoscopy and demonstrates an unusual clinical course.
Zusammenfassung
Siegelringzellkarzinome des Gastrointestinaltraktes können eine diagnostische Herausforderung an den Endoskopiker darstellen. Sie sind oftmals durch atypische Metastasierung und eine schlechte Prognose gekennzeichnet.
In diesem Fallbericht wird ein bei einer 71-jährigen Patientin aufgetretenes Siegelringzellkarzinom mit unklarem Primarius vorgestellt. Nach 6 Zyklen einer FU/FA-Chemotherapie war eine nahezu vollständige Remission des Tumors zu beobachten. Nach 2 Jahren Verlaufsbeobachtung ließ sich eine große Metastase des Siegelringzellkarzinoms im Bereich der Muskulatur des unteren Rückens nachweisen.
Dieser Fallbericht verdeutlicht die mitunter schwierige endoskopische Diagnostik von Siegelringzellkarzinomen und beschreibt einen außergewöhnlichen klinischen Verlauf.
Key words
Signet-Ring Cell Carcinoma - FU/FA Chemotherapy - Unknown Primary Location - Remission
Schlüsselwörter
Siegelringzellkarzinom - FU/FA-Chemotherapie - Unklarer Primärtumor - Remission
References
- 1 Abbruzzese J L, Abbruzzese M C, Hess K R. et al . Unknown primary carcinoma: Natural history and prognostic factors in 657 consecutive patients. J Clin Oncol. 1994; 10 1272-1280
- 2 Vanhoefer U, Wilke H, Weh H J. et al . Weekly high-dose 5-fluorouracil and folinic acid as salvage treatment in advanced gastric cancer. Ann Oncol. 1994; 5 850-851
- 3 Sanaka M, Kuyama Y, Yamanaka M, Tamura Y. A signet-ring cell carcinoma of the stomach endoscopically recognized as a tiny discolored spot. Endoscopy. 1998; 30 S99
- 4 Lugering N, Menzel J, Westermann G, Domschke W. Signet-ring cell carcinoma of the stomach - a case of diagnostic dilemma. Z Gastroenterol. 2000; 38 177-180
- 5 Harris M, Wells S, Vasudev K S. Primary signet-ring cell carcinoma of the breast. Histopathology. 1978; 2 171-176
- 6 Iizawa H, Ikeda E, Sato T, Ohta Y. Signet-ring cell carcinoma of the ileum: Report of a case and review of the Japanese literature. Surg Today. 1998; 28 1168-1171
- 7 McArthur C P, Fiorella R, Saran B M. Rare primary signet-ring carcinoma of the pancreas. Mo Med. 1995; 92 298-302
- 8 Braun E V, Ali M, Fayemi A O, Beaugard E. Primary signet-ring cell carcinoma of the urinary bladder: Review of the literature and report of a case. Cancer. 1981; 47 1430-1435
- 9 Yamauchi K, Ozeki Y, Sumi Y, Yamada T, Koyama H. A case of signet-ring cell carcinoma of the gall bladder with anomalous pancreatobiliary union. Nippon Shokakibyo Gakkai Zasshi. 2000; 97 204-208
- 10 Kuroda N, Yamasaki I, Nakayama H. et al . Prostatic signet-ring cell carcinoma: Case report and literature review. Pathol Int. 1999; 49 457-461
- 11 Hayashi H, Kitamura H, Nakatani Y. et al . Primary signet-ring cell carcinoma of the lung: Histochemical and immunohistochemical characterization. Hum Pathol. 1999; 30 378-383
- 12 Breier F, Feldmann R, Fellenz C, Neuhold N, Gschnait F. Primary invasive signet-ring cell melanoma. J Cutan Pathol. 1999; 26 533-536
- 13 Tungekar M F. Gastric signet-ring cell lymphoma with alpha heavy chains. Histopathology. 1986; 10 725-733
- 14 Suster S, Fletcher C D. Gastrointestinal stromal tumors with prominent signet-ring cell features. Mod Pathol. 1996; 9 609-613
- 15 Secco G B, Fardelli R, Campora E. et al . Primary mucinous adenocarcinomas and signet-ring cell carcinomas of colon and rectum. Oncology. 1994; 51 30-34
- 16 Nissan A, Guillem J G, Paty P B, Wong W D, Cohen A M. Signet-ring cell carcinoma of the colon and rectum: A matched control study. Dis Colon Rectum. 1999; 42 1176-1180
- 17 Psathakis D, Schiedeck T H, Krug F. et al . Ordinary colorectal adenocarcinoma vs. primary colorectal signet-ring cell carcinoma: Study matched for age, gender, grade, and stage. Dis Colon Rectum. 1999; 42 1618-1625
- 18 Friedrich T, Kellermann S, Leinung S. Atypical metastasis of stomach carcinoma. Zentralbl Chir. 1997; 122 117-121
- 19 Giacomini P G, Santeusanio G, Alessandrini M, Bruno E. Laryngeal metastasis from a signet cell carcinoma of the colon. A case report and review of the literature. An Otorhinolaringol Ibero Am. 1998; 25 463-470
- 20 Yokota T, Kunii Y, Teshuma S. et al . Signet-ring cell carcinoma of the stomach: A clinicopathological comparison with the other histological types. Tohoku J Exp Med. 1998; 186 121-130
- 21 Maehara Y, Sakaguchi Y, Moriguchi S. et al . Signet-ring cell carcinoma of the stomach. Cancer. 1992; 69 1645-1650
- 22 Theuer C P, Nastanski F, Brewster W R, Butler J A, Anton-Culver H. Signet-ring histology is associated with unique clinical features but does not affect gastric cancer survival. Am Surg. 1999; 65 915-921
- 23 Santini D, Bazzocchi F, Mazzoleni G. et al . Signet-ring cells in advanced gastric cancer. A clinical, pathological and histochemical study. Acta Pathol Microbiol Immunol Scand. 1987; 95 225-231
- 24 Hainsworth J D, Johnson D H, Greco F A. Cisplatin-based combination chemotherapy in the treatment of poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown primary site: Results of a 12-year experience. J Clin Oncol. 1992; 10 912-922
Dr. med. Jan Heidemann
Department of Medicine B
University of
Münster
Albert-Schweitzer-Straße 33
48129 Münster
Email: Jan_Heidemann@hotmail.com