title: Primary signet-ring cell carcinoma of the urinary bladder successfully managed with cisplatin and gemcitabine: a case report.
abstract: BACKGROUND
  Primary signet-ring cell carcinoma of the urinary bladder is a rare variant of mucus-producing adenocarcinoma constituting approximately 0.5% to 2.0% of all primary carcinomas of the bladder. This tumor initially presents as a high-grade, high-stage lesion and diffusely invades the bladder wall without forming intraluminal growth. The patients have no specific symptoms, which leads to delayed diagnosis and poor prognosis.
  
  
  METHODS
  We report the case of a 51-year-old Moroccan Berber man consulting for gross hematuria. Ultrasonography and a computed tomography scan found a bladder tumor diffusely invading the bladder wall. A histopathological examination of the tumor chips from a transurethral resection of the bladder revealed signet-ring cell adenocarcinoma. The gastrointestinal tract exploration did not reveal any other tumor localization. A radical cystectomy and adjuvant cisplatin and gemcitabine chemotherapy were therefore performed resulting in 18 months of survival without metastasis and a good quality of life within that time.
  
  
  CONCLUSIONS
  The rarity and the successful management with carboplatin and gemcitabine as adjuvant chemotherapy of this entity, which is rarely reported in the literature, are two remarkable characteristics described in this case report.
authors: Department of Urology, University Hospital Center Hassan II, Route Sidi Hrazem, Fez, 30000, Morocco. drahsaini@gmail.com.
authors: Jalal Eddine
authors: JE
authors: El Ammari
authors: Mustapha
authors: M
authors: Ahsaini
authors: Omar
authors: O
authors: Riyach
authors: Mohammed Jamal
authors: MJ
authors: El Fassi
authors: My Hassan
authors: MH
authors: Farih
authors: Nawal
authors: N
authors: Hammas
authors: Hind
authors: H
authors: Elfatmi
authors: Afaf
authors: A
authors: Amarti
references: Am J Pathol. 1955 Mar-Apr;31(2):223-31
references: 14350063
references: Urology. 2002 Apr;59(4):601
references: 11927332
references: Urol Int. 1995;55(1):34-7
references: 7571182
references: Histopathology. 1996 Jan;28(1):33-40
references: 8838118
references: Br J Urol. 1998 Aug;82(2):206-12
references: 9722755
references: Cancer Radiother. 2005 Sep;9(5):332-4
references: 15949964
references: Int J Urol. 2001 Apr;8(4):190-3
references: 11260353