Abstract
Background: Primary signet-ring cell carcinoma of the colon and rectum is a rare form of adenocarcinoma of the large intestine. The purpose of this study was to help better define the natural history of this entity.
Methods: The medical records of 3,690 patients with colorectal cancer seen at The Roswell Park Cancer Institute between September 1971 and December 1993 were reviewed. We report on 29 patients with pathologic confirmation of primary signet-ring cell carcinoma. Patient demographics, clinical, and histologic parameters were evaluated. Survival was calculated by the Kaplan-Meier method.
Results: There was a nearly equal distribution of primary signet-ring cell carcinoma between the right colon and left colon/rectum. In most cases the tumors were >6 cm, ulcerated, and involved the full thickness of the bowel wall. Nodal or metastatic disease was present in 21 of 29 patients (72%) at the time of diagnosis. Four patients (14%) had synchronous colorectal adenocarcinomas. Twenty-two patients died of disease progression. At the time of death, two patients (9%) had failed in the liver, whereas all 22 patients had peritoneal carcinomatosis.
Conclusions: Patients with primary signet-ring cell colorectal carcinoma frequently present with late-stage disease. In 23 of 29 patients, the disease rapidly recurred or progressed. Peritoneal carcinomatosis is the most common pattern of failure.
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References
Fahl JC, Dockerty MB, Judd ES. Scirrhous carcinoma of the colon and rectum.Surg Gynecol Obstet 1960;3:759–66.
Wolfman EF, Astler VB, Coller FA. Mucoid adenocarcinoma of the colon and rectum.Surgery 1957;42:846–52.
Laufman H, Saphir O. Primary linitis plastica type carcinoma of the colon.Arch Surg 1951;62:79–91.
Lui IO, Kung ITM, Lee JMH, Boey JH. Primary colorectal signet-ring cell carcinoma in young patients: report of three cases.Pathology 1985;17:31–5.
Connelly JH, Robey-Cafferty SS, El-Naggar AK, Cleary KR. Exophytic signet-ring cell carcinoma of the colorectum.Arch Pathol Lab Med 1991;115:134–6.
Giacchero U, Aste H, Baracchini P, Conio M, Fulcheri E, Lapertosa G, Tanzi R. Primary signet-ring carcinoma of the large bowel: report of nine cases.Cancer 1985;56:2723–6.
Alamgro UA. Primary signet-ring carcinoma of the colon.Cancer 1978;41:1453–7.
Halvorsen TB, Seim E. Influence of mucinous components on survival in colorectal adenocarcinoma: a multivariate analysis.J Clin Pathol 1988;41:1068–72.
Kallie NR, Fisher GF, Chan CY. Linitis plastica of the cecum.Can J Surg 1980;23:282–4, 307.
Amorn Y, Knight WA Jr. Primary linitis plastica of the colon: report of two cases and review of the literature.Cancer 1978;41:2420–5.
Bonello JC, Quan SHQ, Sternsberg SS. Primary linitis plastica of the rectum.Dis Colon Rectum 1980;23:337–42.
Dailey TH, Garret R. Primary linitis plastica of the rectum: report of two cases.Dis Colon Rectum 1971;14:218–21.
Matthews JL, Coyle D Jr, Little WP. Primary linitis plastica of the rectum: report of a case.Dis Colon Rectum 1982;25:488–90.
Nader L, Mori K, Shinya H. Primary linitis plastica of the colon and rectum: report of two cases.Dis Colon Rectum 1983;26:736–40.
Qizilbach AH. Linitis plastica carcinoma of the intestine: report of four cases.Dis Colon Rectum 1974;17:540–9.
Chowdbury JR, Das K, Das KM. Primary linitis plastica of the colon: report of a case and review of the literature.Dis Colon Rectum 1975;18:332–8.
Rao TR, Hambrick E, Abcarian H, Salgia K, Recant WM. Colorectal linitis plastica.Dis Colon Rectum 1982;25:239–44.
Raskin MM, Viamonte M, Viamonte M Jr. Primary linitis plastica carcinoma of the colon.Radiology 1974;113:17–22.
Sizer JS, Frederick PL, Osborne MP. Primary linitis plastica of the colon: report of a case and review of the literature.Dis Colon Rectum 1967;10:339–43.
Bonello JL, Sternberg SS, Quan SHQ. The significance of the signet-cell variety of adenocarcinoma of the rectum.Dis Colon Rectum 1980;23:180–3.
Speer CS. Linitis plastica carcinoma of the colon: report of a case.Dis Colon Rectum 1971;14:389–93.
Ojeda VJ, Mitchell KM, Walters NI, Gibson MJ. Primary colo-rectal linitis plastica type of carcinoma: report of two cases and review of the literature.Pathology 1982;14:181–9.
Woolam GL, Jackman RJ, Ramirez RF, Beahrs OH, Dockerty MB. Scirrhous carcinoma of the lower intestine.Surg Gynecol Obstet 1965;121:753–5.
Morson BC, Sobin LH.International histological classification of intestinal tumors. Geneva: World Health Organization, 1976.
Kaplan EL, Meier P. Non-parametric estimation from incomplete observations.J Am Stat Soc 1958;53:457–81.
American Joint Committee on Cancer.Manual for staging of cancer, 4th ed. Philadelphia: JB Lippincott, 1992:75–82.
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Anthony, T., George, R., Rodriguez-Bigas, M. et al. Primary signet-ring cell carcinoma of the colon and rectum. Annals of Surgical Oncology 3, 344–348 (1996). https://doi.org/10.1007/BF02305663
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DOI: https://doi.org/10.1007/BF02305663