Signet ring cell carcinoma of the appendix manifesting as colonic obstruction and ovarian tumors: report of a case

Surg Today. 2009;39(3):235-40. doi: 10.1007/s00595-008-3839-y. Epub 2009 Mar 12.

Abstract

Appendiceal cancer is rare and associated with a poor prognosis because it is usually found at an advanced stage. We report a case of appendiceal adenocarcinoma manifesting as a colonic obstruction with a lower abdominal mass. Laparotomy revealed bilateral ovarian tumors and a small appendiceal tumor with peritoneal metastases. We performed ileocecal resection, colectomy, and oophorectomy, following which a histological diagnosis of signet ring cell carcinoma was made. Immunohistochemical analysis revealed positive expression of cytokeratin 7 and 20, and mucin core protein 2 (MUC2), compatible with appendiceal cancer and Kruckenberg metastases. When a patient is found to have disseminated pelvic signet ring cell carcinoma of unknown origin, the appendix should be considered as a possible primary site.

MeSH terms

  • Aged
  • Appendiceal Neoplasms / diagnosis
  • Appendiceal Neoplasms / pathology*
  • Appendiceal Neoplasms / surgery
  • Biomarkers / analysis
  • Carcinoma, Signet Ring Cell / diagnosis
  • Carcinoma, Signet Ring Cell / pathology*
  • Carcinoma, Signet Ring Cell / surgery
  • Female
  • Humans
  • Intestinal Obstruction / diagnosis
  • Intestinal Obstruction / etiology*
  • Intestinal Obstruction / surgery
  • Magnetic Resonance Imaging
  • Ovarian Neoplasms / diagnosis
  • Ovarian Neoplasms / pathology*
  • Ovarian Neoplasms / surgery
  • Peritoneal Neoplasms / diagnosis
  • Peritoneal Neoplasms / secondary
  • Peritoneal Neoplasms / surgery
  • Tomography, X-Ray Computed

Substances

  • Biomarkers