Signet ring cell rectal cancer

Case contributed by Dr Bahman Rasuli

Presentation

Rectal bleeding and weight loss

Patient Data

Age: 50 years
Gender: Female

Marked circumferential wall thickening of the rectum with narrowing of the lumen and water restriction on DWI images measuring about 55 mm length, 7 cm proximal to the anal verge

Anterolateral extension of the rectal mass on the left side with the transgression of mesorectal fascia and invasion of seminal vesicle.

Two abnormal nodes with maximum short axis diameter of 3.5 mm and 6 mm within the mesorectal fascia on the left side.

Three renal cortical simple cysts on the right side.

Case Discussion

Regarding the MRI findings, rectal cancer stage T4b N1b M0 was the final diagnosis.

The mass was resected and pathologic examination revealed:

Microscopic description:

Sections show polyploid fragments of gastric mucosa lined by dysplastic cells with hyperchromic pleomorphic nuclei. There is an invasive neoplastic lesion that includes individual; cells with intracellular mucin(signet ring cells) and focally extracellular infiltrating lamina propria and muscularis mucosa.

Diagnosis: Signet ring carcinoma arising in the adenomatous polyp.

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