title: Exploring signet-ring cells in pregnant female.
abstract: BACKGROUND
  Primary signet-ring cell carcinoma (SRCC) of the colon and rectum are rare form, which present at an advanced stage and have poor prognosis. Different treatment policies of SRCC during different gestational age of pregnancy are explored from the literature.
  
  
  METHODS
  A 26-year-old young pregnant female with 10-week gestation presented with constipation and blood in stools and on per rectal examination a tender circumferential stricture was present 2 cm above the anal verge. Magnetic resonant imaging (MRI) pelvis of the patient revealed rectal thickening, the biopsy of which revealed characteristic appearance of "linitis plastica" and diagnosed as poorly differentiated adenocarcinoma with signet ring morphology with wide spread positivity for cytokeratin & p53. With this diagnosis, patient underwent medical termination of pregnancy (MTP).
  
  
  CONCLUSIONS
  SRCC of the colon comprises about only 1% of all cases of colon cancer. When compared with other types of adenocarcinoma, patients with SRCC in the colon are younger and more likely to experience lymph node metastasis. Its incidence in pregnancy is estimated to be less than 0.1%. Certainly, any pregnant patient who reports rectal bleeding or has hemoccult positive stool on examination deserves careful evaluation to rule out cancer. The complex treatment of colorectal cancer in pregnancy is based on the gestational age of the fetus, tumor stage and need for emergent vs. elective management.
authors.affiliation: 1 Department of Radiation Oncology, 2 Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, India ; 3 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India ; 4 Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Anil Kumar
authors.initials: AK
authors.lastname: Dhull
authors.affiliation: 1 Department of Radiation Oncology, 2 Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, India ; 3 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India ; 4 Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Pooja
authors.initials: P
authors.lastname: Gogia
authors.affiliation: 1 Department of Radiation Oncology, 2 Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, India ; 3 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India ; 4 Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Atri
authors.affiliation: 1 Department of Radiation Oncology, 2 Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, India ; 3 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India ; 4 Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Dhankhar
authors.affiliation: 1 Department of Radiation Oncology, 2 Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, India ; 3 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India ; 4 Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Kaushal
authors.affiliation: 1 Department of Radiation Oncology, 2 Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, India ; 3 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India ; 4 Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sunita
authors.initials: S
authors.lastname: Singh
authors.affiliation: 1 Department of Radiation Oncology, 2 Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, India ; 3 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India ; 4 Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Sen
authors.affiliation: 1 Department of Radiation Oncology, 2 Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, India ; 3 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India ; 4 Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Pal
authors.affiliation: 1 Department of Radiation Oncology, 2 Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, India ; 3 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India ; 4 Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Lathwal
keywords: Signet-ring cell carcinoma (SRCC); colorectal cancer; pregnancy; signet-ring cells
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