title: Multiorganic dissemination of a colorectal signet ring cell carcinoma with fulminant clinical course.
abstract: Mucinous colorectal cancer with signet ring cell aspects is a rare form of adenocarcinoma representing about 2-5% of large bowel neoplasms. The tumor frequently presents with late-stage or peritoneal spreading. It can often affect young patients and diffusely infiltrate through all layers of the intestinal wall. Local recurrence and distant metastases are common in spite of surgical operation and adjuvant treatment, conditioning a poor prognosis. At the present, early diagnosis and complete resection are the most important approaches to improve the outcome. In our report we describe a case of a 41-yr-old patient with very aggressive untreated metastatic colorectal signet ring cell carcinoma. The fulminant tumor progression was really unexpected and misled every possible medical interpretation, leading to rapid worsening of the patient's clinical conditions and no chance for chemotherapy treatment. The tumor mimicked the picture observed in the acute leukemia, developing diffuse infiltration in all serosal membranes, liver, lung, kidneys, multiple lymph nodes, and meninges, as revealed by the post-mortem medical report.
authors.affiliation: Division of Medical Oncology, San Filippo Neri Hospital, Rome, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Longo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Morabito
authors.forename: Guido
authors.initials: G
authors.lastname: Carillio
authors.forename: Giovanna
authors.initials: G
authors.lastname: Lanzi
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Castellana
authors.forename: Scolastica
authors.initials: S
authors.lastname: Amici
authors.forename: Massimo
authors.initials: M
authors.lastname: Fanelli
authors.forename: Domenico
authors.initials: D
authors.lastname: Gattuso
authors.forename: Giampietro
authors.initials: G
authors.lastname: Gasparini
mesh_terms: D000328:Adult; D001344:Autopsy; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000473:pathology*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis / Q000473:pathology*