alexa
Reach Us +44-1993-227344
Signet-Ring Cell Gastric Carcinoma Metastatic to Bladder | OMICS International
ISSN: 2165-7920
Journal of Clinical Case Reports
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Signet-Ring Cell Gastric Carcinoma Metastatic to Bladder

Rodrigo Da Silva1, Gustavo Neves de Araujo2*, Catiucia Carneiro Lopes Hommerding1, Karla Cristina Censi3, Sheila Piccoli Garcia2, Fernanda Cano Casarotto4, Eduardo Sprinz5 and Brasil Silva Neto6
1Surgery Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
2Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
3Universidade de Caxias do Sul, Caxias do Sul, Brazil
4Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
5Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
6Surgery Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Corresponding Author : Gustavo Araujo
Hospital de Clinicas de Porto Alegre
Porto Alegre, Rio Grande do Sul Brazil
Tel: 55 51 3359-8000
E-mail: [email protected]
Received May 08, 2015; Accepted July 18, 2015; Published July 25, 2015
Citation: Silva RD, de Araujo GN, Hommerding CCL, Censi KC, Garcia SP, et al. (2015) Signet-Ring Cell Gastric Carcinoma Metastatic to Bladder. J Clin Case Rep 5:559. doi:10.4172/2165-7920.1000559
Copyright: © 2015 Silva RD, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Related article at Pubmed, Scholar Google

Visit for more related articles at Journal of Clinical Case Reports

Abstract

Bladder Signet-Ring Cell Carcinoma (SRCC) is extremely rare. It is most often primary, but metastatic disease is described in a few cases in literature. Herein we describe a case of primary SRCC of the stomach with metastasis to the bladder that did not have the chance to receive treatment and passed away due to tumor aggressiveness. We also reviewed the literature and discussed the etiology, prognosis and treatment of bladder SRCC.

Keywords
Bladder; Carcinoma; Metastasis
Introduction
Bladder Signet-Ring Cell Carcinoma (SRCC) is extremely rare, representing a maximum of 2% of all bladder cancers [1,2]. It is most often primary, but metastatic disease is described in a few cases in literature. Due to low response to chemotherapy and radiotherapy, this is a cancer of poor prognosis [2]. Herein we describe a case of primary SRCC of the stomach with metastasis to the bladder that did not have the chance to receive treatment and passed away due to tumor aggressiveness.
Case Presentation
A previously healthy 40 year-old woman was admitted to the emergency department with abdominal pain and bilious vomiting associated with weight loss of 4-6 kg in one month. The arrival laboratory tests did not show significant alterations. Computed Tomography (CT) of the abdomen (Figure 1) showed gastric thickening in the body and antrum with mesocolic fat infiltration and regional lymphadenopathy. There was phrenic, gastro-hepatic, celiac, retroperitoneal and pelvic lymphnode enlargement. The survey also showed an infiltrative lesion in the right lateral wall of the bladder.
On the 6th day of hospitalization the patient developed hematemesis. Upper endoscopy was performed. The examination visualized an infiltrated mucosa with gorgeous pleating stretching involving the gastric body, especially the greater curvature, anterior and posterior wall, with vegetating, ulcerated and necrotic areas. A gastric ulcer biopsy performed during endoscopy confirmed diagnosis of poorly differentiated adenocarcinoma, diffuse-type with signet ring cells, according to the Laurenn Classification.
For cancer clinical staging we performed bone scintigraphy and chest/abdomen CT. The first exam showed no changes. However, chest CT identified two micronodules in the lung parenchyma and increased supraclavicular and mediastinal lymph nodes. Also, it was diagnosed pulmonary thromboembolism (subclinical), and anticoagulation was contraindicated due to active gastrointestinal bleeding and hematuria. The comparative abdominal CT performed 29 days after the arrival (Figure 2) showed increased infiltrative lesion in the right lateral wall of the bladder with involvement of the distal ureter. The approach of the bladder lesion was made by Trans-Urethral Resection (TUR), which confirmed metastatic disease. Bladder biopsy showed signet ring cells (Figure 3) and lymphatic involvement (Figure 4). Abdominal CT also identified an infiltration and blurring of the hepatic hilum with dilated intrahepatic bile duct. Cholestasis was caused by extrinsic compression of the biliary tract, and the patient was submitted to trans-hepatic cholangiography with endovascular stent placement and drainage of bile.
The patient developed septic shock, and broad-spectrum antibiotics were started. She was transferred to the intensive care unit, persisting with hemodynamic instability, with multiple organ dysfunction syndromes. In spite of full treatment there was refractory shock, she passed away.
Case Discussion
The SRCC variant is a very rare entity, with only 10 cases reported so far [3-11]. When diagnosed in the bladder, SRCC is more likely to be a primary tumor. However, metastasis from a primary gastrointestinal tumor should also be considered and an appropriate investigation to identify these primary lesions should be done due to the difference in treatment between primary and metastatic type [4].
Metastatic tumors in the urinary bladder are uncommon, accounting for 1% of all bladder cancers. In the case of bladder involvement by direct extension, the most common primary sites are colon, prostate, rectum, and cervix. However, in the case of distant metastases, the most common primary tumor sites are skin (melanoma), breast and stomach [12].
Treatment of variants of the signet ring cell carcinoma of bladder is not well defined, due to the rarity of the tumor. The primary types are generally treated surgically, while the metastatic type preferably treated by chemotherapy. Due to aggressiveness, early metastasis and presence of advanced stages when diagnosis, prognosis is poor, with a mean survival of one to one and a half year after diagnosis [13-15].
Conclusion
Signet ring cell carcinoma in the bladder is a rare neoplasm that can present as either a primary or metastatic tumor. A history of cancer should raise the possibility of metastatic disease. Occasionally, the bladder may be the first metastatic manifestation of an occult primary neoplasm, usually of gastrointestinal origin. The overall outcome for signet ring cell carcinoma is generally quite poor.
References
 















 

Figures at a glance

Figure Figure Figure Figure
Figure 1 Figure 2 Figure 3 Figure 4
Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Article Usage

  • Total views: 12093
  • [From(publication date):
    July-2015 - Nov 21, 2018]
  • Breakdown by view type
  • HTML page views : 8282
  • PDF downloads : 3811
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2018-19
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri and Aquaculture Journals

Dr. Krish

[email protected]

+1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

streamtajm

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2018 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version