title: Signet-ring cell carcinoma of the ileum: report of a case and review of the Japanese literature.
abstract: We report herein the extremely unusual case of a 71-year-old woman with signet-ring cell carcinoma of the ileum. She originally presented with a 6-month history of intermittent nausea and abdominal distention, but initial examinations, including gastrointestinal fiberscopy, ultrasonography, and computed tomography (CT) scan, failed to reveal any cause of her symptoms. A barium-enema study performed 11 months after her initial visit demonstrated a narrow portion of the terminal ileum. An ileocecal resection was subsequently performed, and an epigastric subcutaneous tumor was simultaneously excised. The specimen contained a tumor with a stenotic lumen resembling a "lead pipe", an ulcerative portion, and mucosa with a granular appearance adjoining its proximal site. Many small aphthous lesions with IIa + IIc appearance were seen in the apparently normal mucosa. Histopathological examination confirmed a diagnosis of signet-ring cell carcinoma. The small aphthous lesions seemed to be metastases spread via the lymphatic vessels. Our review of the medical literature revealed three cases of signet-ring cell carcinoma of the jejunum; however, this is the first reported case of signet-ring cell carcinoma of the ileum.
authors.affiliation: Department of Surgery, Yamagata Prefectural Central Hospital, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Iizawa
authors.forename: E
authors.initials: E
authors.lastname: Ikeda
authors.forename: T
authors.initials: T
authors.lastname: Sato
authors.forename: Y
authors.initials: Y
authors.lastname: Ohta
mesh_terms: D000368:Aged; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000473:pathology*; D007564:Japan