Research Article
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Year 2021, Volume: 8 Issue: 2, 88 - 90, 30.06.2021

Abstract

References

  • 1. Benesch MGK, Mathieson A. Epidemiology of signet ring cell adenocarcinomas. Cancers 2020;12(6):1544.
  • 2. Arai T. Where does signet-ring cell carcinoma come from and where does it go? Gastric Cancer 2019;22(4):651-2.
  • 3. World Health Organization editorial board. Digestive system tumours, WHO classification of tumours series. 5th ed. Lyon: International Agency for Research on Cancer; 2019.
  • 4. San-Gang W, Xue-Ting C, Wen-Wen Z et al. Survival in signet ring cell carcinoma varies based on primary tumor location: a surveillance, epidemiology, and end results database analysis. Expert Rev. Gastroenterol Hepatol 2018;12(2):209-14.
  • 5. Pernot S, Voron T, Perkins G et al. Signet-ring cell carcinoma of the stomach: impact on prognosis and specific therapeutic challenge. World J Gastroenterol 2015;21(40):11428-38.
  • 6. Machlowska J, Pucułek M, Sitarz M et al. State of the art for gastric signet ring cell carcinoma: from classification, prognosis, and genomic characteristics to speci- fied treatments. Cancer Manag Res 2019;11:2151-61.
  • 7. Li Y, Zhu Z, Ma F et al. Gastric signet ring cell carcinoma: current management and future challenges. Cancer Manag Res 2020;12:7973-81.
  • 8. Hundahl SA, Phillips JL, Menck HR. The national cancer data base report on poor survival of U.S. gastric carcinoma patients treated with gastrectomy: fifth edition American Joint Committee on Cancer staging, proximal disease, and the "different disease" hypothesis. Cancer 2000;88:921-32.
  • 9. Wanebo HJ, Kennedy BJ, Chmiel J et al. Cancer of the stomach: a patient care study by the american college of surgeons. Ann Surg 1993;218:583-92.
  • 10. Turkoz FP, Solak M, Kilickap S et al. Bone metastasis from gastric cancer: the in- cidence, clinicopathological features, and influence on survival. J Gastric Cancer 2014;14(3):164-72.
  • 11. Lauren P. The two histological main types of gastric carcinoma: diffuse and so- called intestinal-type carcinoma: an attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 1965;64:31-49.
  • 12. Takayasu V, Goto EH, Casagrande MZ et al. Bicytopenia and leukoerythroblasto- sis: a rare initial presentation of signet ring cell gastric adenocarcinoma. Autops Case Rep 2017;7(2):55-60.
  • 13. Kim HS, Yi SY, Jun HJ et al. Clinical outcome of gastric cancer patients with bone marrow metastases. Oncology 2007;73(3-4):192-7.
  • 14. Kusumoto H, Haraguchi M, Nozuka Y et al. Characteristic features of disseminat- ed carcinomatosis of the bone marrow due to gastric cancer: the pathogenesis of bone destruction. Oncol Rep 2006;16(4):735-40.
  • 15. Ekinci AŞ, Bal O, Ozatlı T et al. Gastric carcinoma with bone marrow metastasis: a case series. J Gastric Cancer 2014;14(1):54-7.
  • 16. Iguchi H. Recent aspects for disseminated carcinomatosis of the bone marrow associated with gastric cancer: what has been done for the past, and what will be needed in future? World J Gastroenterol 2015;21(43):12249-60.
  • 17. Fonocho E, Aydin N, Reddy S et al. Recurrent gastric cancer metastasizing to the bone marrow: a case report of a rare presentation. Int J Surg Case Rep 2017;37:165-8.

A RARE CASE OF RECURRENT SIGNET RING CELL CARCINOMA PRESENTING WITH THROMBOCYTOPENIA

Year 2021, Volume: 8 Issue: 2, 88 - 90, 30.06.2021

Abstract

Aims: Signet ring cell carcinoma is a rare type of gastric cancer most commonly seen in the stomach. There is a 60% systemic recurrence rate of gastric cancer after curative resection, and it most commonly recurs in the liver, peritoneum, and lungs. Bone metastasis is extremely rare in gastric cancer. We aim to present a rare case of signet ring cell carcinoma with thrombocytopenia as a primary symptom of bone marrow metastasis years after the patient’s primary diagnosis with gastric adenocarcinoma. Case Report: A 52-year-old male patient was admitted to the Medical Oncology Division of Trakya University Hospital with dyspeptic complaints six years ago, whereupon gastroscopy revealed an ulcerated lesion in the antral region of the stomach, and the pathological biopsy revealed adeno- carcinoma. The patient underwent subtotal gastrectomy and lymph node dissection, combined with adjuvant chemoradiotherapy. In the follow-up, a complete blood count revealed thrombocytopenia, and poorly differentiated adenocarcinoma metastasis with a signet ring cell component was demonstrated through imaging studies and pathological examination. Treatment with cisplatin and 5-fluorouracil was initiated after the diagnosis of human epidermal growth factor receptor-2 negative, stage 4 gastric adenocarcinoma. The patient showed clinical and laboratory response to the treatment and will continue with the current regimen. Conclusion: In this case, the primary tumor was in the stomach, and he had signs of thrombocytopenia only. When the prognosis of the patient was evaluated, it was thought that there was tumor residue at a cellular or clonal level in the stomach after gastrectomy, or an asymptomatic metastasis present and unnoticed in the bone marrow during the surgical treatment. In conclusion, this case shows that physicians should be alert to the changes in blood parameters in terms of recurrence with bone marrow involvement even if there is no visible recurrence in the patient.

References

  • 1. Benesch MGK, Mathieson A. Epidemiology of signet ring cell adenocarcinomas. Cancers 2020;12(6):1544.
  • 2. Arai T. Where does signet-ring cell carcinoma come from and where does it go? Gastric Cancer 2019;22(4):651-2.
  • 3. World Health Organization editorial board. Digestive system tumours, WHO classification of tumours series. 5th ed. Lyon: International Agency for Research on Cancer; 2019.
  • 4. San-Gang W, Xue-Ting C, Wen-Wen Z et al. Survival in signet ring cell carcinoma varies based on primary tumor location: a surveillance, epidemiology, and end results database analysis. Expert Rev. Gastroenterol Hepatol 2018;12(2):209-14.
  • 5. Pernot S, Voron T, Perkins G et al. Signet-ring cell carcinoma of the stomach: impact on prognosis and specific therapeutic challenge. World J Gastroenterol 2015;21(40):11428-38.
  • 6. Machlowska J, Pucułek M, Sitarz M et al. State of the art for gastric signet ring cell carcinoma: from classification, prognosis, and genomic characteristics to speci- fied treatments. Cancer Manag Res 2019;11:2151-61.
  • 7. Li Y, Zhu Z, Ma F et al. Gastric signet ring cell carcinoma: current management and future challenges. Cancer Manag Res 2020;12:7973-81.
  • 8. Hundahl SA, Phillips JL, Menck HR. The national cancer data base report on poor survival of U.S. gastric carcinoma patients treated with gastrectomy: fifth edition American Joint Committee on Cancer staging, proximal disease, and the "different disease" hypothesis. Cancer 2000;88:921-32.
  • 9. Wanebo HJ, Kennedy BJ, Chmiel J et al. Cancer of the stomach: a patient care study by the american college of surgeons. Ann Surg 1993;218:583-92.
  • 10. Turkoz FP, Solak M, Kilickap S et al. Bone metastasis from gastric cancer: the in- cidence, clinicopathological features, and influence on survival. J Gastric Cancer 2014;14(3):164-72.
  • 11. Lauren P. The two histological main types of gastric carcinoma: diffuse and so- called intestinal-type carcinoma: an attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 1965;64:31-49.
  • 12. Takayasu V, Goto EH, Casagrande MZ et al. Bicytopenia and leukoerythroblasto- sis: a rare initial presentation of signet ring cell gastric adenocarcinoma. Autops Case Rep 2017;7(2):55-60.
  • 13. Kim HS, Yi SY, Jun HJ et al. Clinical outcome of gastric cancer patients with bone marrow metastases. Oncology 2007;73(3-4):192-7.
  • 14. Kusumoto H, Haraguchi M, Nozuka Y et al. Characteristic features of disseminat- ed carcinomatosis of the bone marrow due to gastric cancer: the pathogenesis of bone destruction. Oncol Rep 2006;16(4):735-40.
  • 15. Ekinci AŞ, Bal O, Ozatlı T et al. Gastric carcinoma with bone marrow metastasis: a case series. J Gastric Cancer 2014;14(1):54-7.
  • 16. Iguchi H. Recent aspects for disseminated carcinomatosis of the bone marrow associated with gastric cancer: what has been done for the past, and what will be needed in future? World J Gastroenterol 2015;21(43):12249-60.
  • 17. Fonocho E, Aydin N, Reddy S et al. Recurrent gastric cancer metastasizing to the bone marrow: a case report of a rare presentation. Int J Surg Case Rep 2017;37:165-8.
There are 17 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case Report
Authors

Sezin Sayın 0000-0001-7892-5992

Elçin Kasapoğlu 0000-0001-7888-1053

Ali Gökyer 0000-0002-1653-6155

Publication Date June 30, 2021
Submission Date April 3, 2021
Published in Issue Year 2021 Volume: 8 Issue: 2

Cite

APA Sayın, S., Kasapoğlu, E., & Gökyer, A. (2021). A RARE CASE OF RECURRENT SIGNET RING CELL CARCINOMA PRESENTING WITH THROMBOCYTOPENIA. Turkish Medical Student Journal, 8(2), 88-90.
AMA Sayın S, Kasapoğlu E, Gökyer A. A RARE CASE OF RECURRENT SIGNET RING CELL CARCINOMA PRESENTING WITH THROMBOCYTOPENIA. TMSJ. June 2021;8(2):88-90.
Chicago Sayın, Sezin, Elçin Kasapoğlu, and Ali Gökyer. “A RARE CASE OF RECURRENT SIGNET RING CELL CARCINOMA PRESENTING WITH THROMBOCYTOPENIA”. Turkish Medical Student Journal 8, no. 2 (June 2021): 88-90.
EndNote Sayın S, Kasapoğlu E, Gökyer A (June 1, 2021) A RARE CASE OF RECURRENT SIGNET RING CELL CARCINOMA PRESENTING WITH THROMBOCYTOPENIA. Turkish Medical Student Journal 8 2 88–90.
IEEE S. Sayın, E. Kasapoğlu, and A. Gökyer, “A RARE CASE OF RECURRENT SIGNET RING CELL CARCINOMA PRESENTING WITH THROMBOCYTOPENIA”, TMSJ, vol. 8, no. 2, pp. 88–90, 2021.
ISNAD Sayın, Sezin et al. “A RARE CASE OF RECURRENT SIGNET RING CELL CARCINOMA PRESENTING WITH THROMBOCYTOPENIA”. Turkish Medical Student Journal 8/2 (June 2021), 88-90.
JAMA Sayın S, Kasapoğlu E, Gökyer A. A RARE CASE OF RECURRENT SIGNET RING CELL CARCINOMA PRESENTING WITH THROMBOCYTOPENIA. TMSJ. 2021;8:88–90.
MLA Sayın, Sezin et al. “A RARE CASE OF RECURRENT SIGNET RING CELL CARCINOMA PRESENTING WITH THROMBOCYTOPENIA”. Turkish Medical Student Journal, vol. 8, no. 2, 2021, pp. 88-90.
Vancouver Sayın S, Kasapoğlu E, Gökyer A. A RARE CASE OF RECURRENT SIGNET RING CELL CARCINOMA PRESENTING WITH THROMBOCYTOPENIA. TMSJ. 2021;8(2):88-90.