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Signet ring cell carcinoma

Signet ring cell carcinoma
File:Signet ring cell carcinoma - very high mag.jpg
A signet ring cell carcinoma of the stomach. Signet ring cells are seen in the lower half of the image. Gastric epithelium is seen in the upper half of the image. H&E stain.
Classification and external resources
ICD-O M8490/3
NCI Signet ring cell carcinoma
Patient UK Signet ring cell carcinoma
MeSH D018279

Signet ring cell carcinoma (SRCC) is an epithelial malignancy characterized by the histologic appearance of signet ring cells.

It is a form of adenocarcinoma,[1] that produces mucin. When the adenocarcinoma contains more than 50% signet rings it is referred to as a signet ring cell carcinoma.[2] It is most often found in the glandular cells of the stomach, but it may develop in other areas of the body.[3] e.g. the prostate,[4] bladder, gallbladder,[5] breast, colon,[6] ovarian stroma and testis.[7] It may also be seen in renal cell carcinoma. However many SRCC cases are rare. SRCC do not normally form in the lungs, stomach, or urinary bladder but there have been a few incidents where signet ring cell carcinoma has been reported in these areas. The SRCC in the stomach mainly appears in women and younger patients, while the SRCC of the urinary bladder occurs mainly in men around the ages of 38 to 83.[8]

Some cases (not all) are inherited, and these cases are often caused by mutations in the CDH1 gene.[9]


The mechanism of this malignant cancer is still unclear, however it has been found that a colon carcinoma cell known as HCC2998 causes an increase in differentiated tumor production.The reason for this increase is due to the active PI3K that were "converted to a signet ring carcinoma-like cells".[10]


The pattern of metastases is different for gastric signet cell carcinoma than for intestinal-type gastric carcinoma. In cases where gastric signet cell carcinoma metastasizes, it tends to spread to peritoneal metastases, lymphatic permeation of the lungs, and to the ovaries, creating Krukenberg tumors.[11]

Histologic appearance

Main article: signet ring cell

Signet ring cells resemble signet rings because a large vacuole full of mucin displaces the nucleus to the periphery.

Prognosis, by organ

In a group of 154 Japanese patients the overall median survival time was 12.7 months and the 5-year survival rate was 9.4%.[6]

Additional images


  1. ^ el-Zimaity HM, Itani K, Graham DY (October 1997). "Early diagnosis of signet ring cell carcinoma of the stomach: role of the Genta stain". J. Clin. Pathol. 50 (10): 867–8. PMC 500272. PMID 9462273. doi:10.1136/jcp.50.10.867. 
  2. ^ "Pure Signet-ring Cell Carcinoma of Lung by Fine Needle Aspiration in a Smoking Asian American: Case Report and Literature Review" (PDF). Clinical & Experimental Pathology. pp. 1985–1990. Retrieved 2014-10-29. 
  3. ^ "What is a Signet Cell Cancer?". CancerHelp UK. Cancer Research UK. Retrieved 2/12/12.  Check date values in: |accessdate= (help)
  4. ^ Leong FJ, Leong AS, Swift J (1996). "Signet-ring carcinoma of the prostate". Pathol. Res. Pract. 192 (12): 1232–8; discussion 1239–41. PMID 9182294. doi:10.1016/S0344-0338(96)80156-7. 
  5. ^ Jain V, Gupta K, Kudva R, Rodrigues GS (2006). "A case of ovarian metastasis of gallbladder carcinoma simulating primary ovarian neoplasm: diagnostic pitfalls and review of literature". Int. J. Gynecol. Cancer. 16 Suppl 1: 319–21. PMID 16515613. doi:10.1111/j.1525-1438.2006.00335.x. 
  6. ^ a b Makino T, Tsujinaka T, Mishima H et al. (2006). "Primary signet-ring cell carcinoma of the colon and rectum: report of eight cases and review of 154 Japanese cases". Hepatogastroenterology 53 (72): 845–9. PMID 17153438. 
  7. ^ Michal M, Hes O, Kazakov DV (2005). "Primary signet-ring stromal tumor of the testis". Virchows Arch. 447 (1): 107–10. PMID 15909171. doi:10.1007/s00428-005-1218-2. 
  8. ^ "Primary Signet-Ring Cell Carcinoma of the Urinary Bladder". Cancer. pp. 1985–1990. Retrieved 2014-10-29. 
  9. ^ "Office of Rare Diseases Research: Diffuse Gastric Cancer". National Institute of Health. National Institute of Health. pp. 84–85. Retrieved 12/21/11.  Check date values in: |accessdate= (help)
  10. ^ "Mechanism behind signet ring cell carcinoma formation". Biochemical and Biophysical Research communications. Science direct. pp. 1231–1233. Retrieved 2014-10-21. 
  11. ^ "Patterns of metastases in intestinal and diffuse types of carcinoma of the stomach". Science Direct (Elsevier) 12 (3): 237–242. 1981. doi:10.1016/S0046-8177(81)80124-4. Retrieved April 11, 2012. 

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