title: Metastatic gallbladder adenocarcinoma with signet-ring cells: A case report.
abstract: BACKGROUND
  Signet-ring cell carcinoma is a rare and aggressive variant of mucinous adenocarcinoma. Only a few cases of gallbladder adenocarcinoma with signet-ring cells have been reported and because of this there is a lack of knowledge about the behavior and biology of this pathology.
  
  
  METHODS
  We present the case of a 63-year-old Arab man with gallbladder signet-ring cell adenocarcinoma. He had an elective cholecystectomy and refused chemotherapy. Two months later, a small hepatic metastatic nodule was found, and nine months later he presented with multiple metastases in the liver, lymphatic nodes, both pleuras, peritoneum and subcutaneous tissue.
  
  
  CONCLUSIONS
  The proliferation of signet-ring cells in a gallbladder adenocarcinoma worsens the prognosis of an already adverse neoplasm. New lines of treatment in chemotherapy, such as cisplatin, or new biological therapy, such as monoclonal antibody c-myc oncogene, should be encouraged to improve the survival and life quality of these oncologic patients.
authors.affiliation: Department of Radiology, Parc de Salut Mar Hospital, Barcelona, Cataluña, Spain. LBazan@parcdesalutmar.cat.
authors.forename: Fernando
authors.initials: F
authors.lastname: Bazan
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchez
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Aguilar
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Radosevic
authors.forename: Marcos
authors.initials: M
authors.lastname: Busto
authors.forename: Flavio
authors.initials: F
authors.lastname: Zuccarino
authors.forename: Lara
authors.initials: L
authors.lastname: Pijuan
authors.forename: Noelia
authors.initials: N
authors.lastname: Risueño