Theme |
Proceedings of 13th Annual Meeting on Colorectal IIc Lesions |
Title |
Case of rectal signet-ring cell carcinoma |
Publish Date |
2004/07 |
Author |
Naoto Miyake |
Department of Gastroenterology, JR Sendai Hospital |
Author |
Tomoki Matsuda |
Department of Gastroenterology, JR Sendai Hospital |
Author |
Masao Ando |
Department of Gastroenterology, JR Sendai Hospital / Department of Gastroenterology, Kanagami Hospital |
Author |
Takeshi Kawasaki |
Department of Gastroenterology, JR Sendai Hospital |
Author |
Toshiyuki Mishima |
Department of Gastroenterology, JR Sendai Hospital |
Author |
Toshihiro Kusaka |
Department of Gastroenterology, JR Sendai Hospital |
Author |
Shyuu Abe |
Department of Gastroenterology, JR Sendai Hospital |
Author |
Junichi Ishibashi |
Department of Gastroenterology, JR Sendai Hospital |
Author |
Kouichi Sugiyama |
Department of Gastroenterology, JR Sendai Hospital |
Author |
Akimichi Chonan |
Department of Gastroenterology, JR Sendai Hospital |
Author |
Fukuji Mochizuki |
Department of Gastroenterology, JR Sendai Hospital |
[ Summary ] |
A fifty four year-old woman visited our hospital because of fecal occult blood. Endoscopic examination revealed an elevated lesion in the lower rectum and a reddish protrusion with yellow mucus in the oral side of the lesion. The biopsy was diagnosed as signet-ring cell carcinoma. Magnifying endoscopy showed a type VN pit pattern in the major part of the lesion and a type I pit was scattered over the slightly elevated area. Endoscopic ultrasonography confirmed thinning of the submucosal layer due to extension of the tumor and low echoic areas in the submucosal layer. A barium enema showed a flat tumor with a small barium pool in the rectum. A Mile's operation was performed. The specimen was an elevated lesion, measuring 45X42 mm in size. Histological examination confirmed signet-ring cell carcinoma, with a depth of a1, on the oral side. In the major part of the tumor, mucosal cancer remained. In the anal side of the lesion, signet-ring cell carcinoma was revealed on the surface of the mucosa, with normal ducts in the deeper part. The normal ducts were observed to remain in the whole mucosal layer in various places. Almost all of signet-ring cell carcinomas of the colon and rectum were of the diffuse infiltrating type. We reported a rare case of signet-ring cell carcinoma the major part of which was mucosal cancer. |