Korean J Urol.  2009 Feb;50(2):188-191.

Primary Signet Ring Cell Carcinoma of the Urinary Bladder

• Jung S
• Jung S
• Min K
• Chung JI
• Choi S
• Kang D

Abstract

Primary signet ring cell carcinoma of the urinary bladder is a relatively rare histological variant of mucus-producing adenocarcinoma usually of poor prognosis. We report two cases of primary bladder signet ring carcinoma. The first patient underwent a radical cystectomy with ileal conduit (pT3bN1M0), radiotherapy, and chemotherapy (M-VAC regimen) and subsequently expired 37 months after surgery. The other was initially diagnosed with peritoneal metastasis from the primary bladder signet ring cell carcinoma and was treated with partial cystectomy (pT3bNOM1). Postoperative adjuvant therapy was not done because of patient's refusal.

Keyword

Carcinoma, signet ring cell; Urinary bladder

MeSH Terms

Adenocarcinoma
Carcinoma, Signet Ring Cell
Cystectomy
Disulfiram
Humans
Neoplasm Metastasis
Prognosis
Urinary Bladder
Urinary Diversion
Disulfiram

Figure

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  Fig. 1 Abdominopelvic computed tomography showing an invasive bladder tumor that extended to the anterior omentum and mesenteric fat. (A) and (B) show the enhanced mass that extended from the anterior bladder wall to the dome, with perivesical streaky density (arrow). (C) and (D) reveal irregular thickening of the peritoneum, omentum, and mesenteric fat, which was suspected in the peritoneal seeding of the malignancy (arrow head).

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  Fig. 2 (A) Tumor mass of case 2 was almost entirely composed of nested or lobular arrangement of signet ring cells. (B) There were also some fragment of surface urothelium showing intestinal metaplasia.

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  Fig. 3 [18F]fluorodeoxyglucose-positron emission tomography (FDG-PET) showing increased FDG uptake (arrow) in the left lower quadrant of the abdomen in axial (A) and coronal (B) views, which suggests metastasis to the peritoneum.

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