Differential Trends in the Intestinal and Diffuse Types of Gastric Carcinoma in the United States, 1973-2000: Increase in the Signet Ring Cell Type

Abstract Context.—During the last 50 years, the incidence and mortality of gastric cancer has declined in many countries. This decline has primarily included the intestinal type (Lauren classification). However, there is an impression among pathologists that the diffuse type, especially the signet ring cell subtype, has become more prevalent. Objectives.—Using data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, we analyzed the trends of the 2 primary types (intestinal and diffuse) of gastric carcinomas from 1973 through 2000. Design.—Trends in age-adjusted rates were determined for gastric carcinomas through the SEER statistical program (SEER*Stat), which is available on the Internet to the public. Results.—During the period studied, the intestinal type continued to decline in males, females, African Americans, and whites. The intestinal type was more common in males than in females and more common in African Americans than in whites. In contrast, a consistent increase in the rate of the diffuse type of gastric carcinoma was seen during this period. The rate increased from 0.3 cases per 100 000 persons in 1973 to 1.8 cases per 100 000 persons in 2000. This increase was seen in males, females, African Americans, and whites. The predominant increase occurred in the signet ring type. Conclusions.—The results indicate a progressive decrease in the incidence of the intestinal type of gastric cancer and an increase in the diffuse type of gastric carcinoma, especially the signet ring cell type. The clinical implications of the increase are considered.

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Adenocarcinoma of the Lung Metastatic to the Ovary With a Signet Ring Cell Component

International Journal of Surgical Pathology ◽

10.1177/1066896917691613 ◽

2017 ◽

Vol 25 (4) ◽

pp. 365-367 ◽

Cited By ~ 6

Author(s):

Giovanna Giordano ◽

Nelly Cruz Viruel ◽

Enrico Maria Silini ◽

Francisco F. Nogales

Keyword(s):

Gastric Carcinoma ◽

Lung Adenocarcinoma ◽

Past History ◽

Signet Ring Cell ◽

Cell Type ◽

Cell Component ◽

Napsin A ◽

Signet Ring ◽

Metastatic Lung ◽

Ring Cell

A nonsmoker 45-year-old woman, presented with a solid right ovarian mass. Microscopic examination revealed heterogeneous histology with tubular formations and extensive signet ring cell component that resembled the usual appearance of metastatic gastric carcinoma to the ovary. Moreover, the histology also showed solid nests of cells with a microvacuolated basophilic cytoplasm similar to those found in adenosquamous cervical carcinoma of glassy cell type. However, analysis of the patient’s past history revealed a lung adenocarcinoma, diagnosed 4 years before, which prompted an immunohistochemical differential diagnosis, showing a strong expression for TTF-1 and Napsin A. A cervical primary was excluded taking into account both macroscopic findings and the negative expression of PAX8 and absence of human papillomavirus–related marker p16. This confirmed the pulmonary origin of ovarian tumor despite its heterogeneous morphology. This is the first reported case of ovarian metastatic lung adenocarcinoma, with a signet ring cell component and solid nests, mimicking both metastatic gastric carcinoma and adenosquamous carcinoma of glassy cell type.

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Signet ring cell gastric carcinoma: A descriptive analysis of a unique county population.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.32 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 32-32

Author(s):

Mital Patel ◽

Neha Patel ◽

James H. Tabibian ◽

Nora Ostrzega

Keyword(s):

Gastric Carcinoma ◽

Patient Population ◽

Serum Antibody ◽

The United States ◽

Signet Ring Cell ◽

Minority Population ◽

Signet Ring ◽

Predominantly Minority ◽

Seer Data ◽

Ring Cell

32 Background: Signet ring cell type gastric carcinoma (SRCC) is an uncommon epithelial malignancy of the stomach, with data from the United States (US) being particularly scarce. Compared to other gastric carcinoma types, it has a female predominance, younger age at diagnosis, and late presentation, making treatment particularly challenging. Recent reports suggest this disease may be increasing among even younger patients, for reasons which remain unclear. We aimed to examine the occurrence, features, and outcomes of SRCC in a predominantly minority Los Angeles County patient population. Methods: We identified all patients diagnosed with SRCC at Olive View-UCLA Medical Center (OVMC) from 2004-2017. Clinico-demographic, imaging, and pathologic data were reviewed and analyzed and compared descriptively to available Surveillance, Epidemiology, and End Results (SEER) data. Results: Sixty-six cases of SRCC were identified, of which 77% were Latino, 9% White, 6% Armenian, and the remaining 8% other. Mean age at SRCC diagnosis was 52 years, and 37 (56%) of patients were female. H. pylori infection was present in 35% (43% diagnosed by serum antibody, 35% by pathology, 9% by stool antigen, and 13% by combination). Follow-up was available for 91% of patients. Median survival was 1 year, and 5-year survival was 7%, markedly lower than the 31% reported in SEER. Seventy-two percent of patients were deceased or on hospice within 2 years of diagnosis. Conclusions: In this first US study to assess the clinical epidemiology of SRCC in a predominantly minority population: 1) the mean age of diagnosis was younger than reported in previous studies (55-61 years), 2) the proportion of males was high compared to SEER data, and 3) survival was considerably lower than previously reported. Insofar as the patient population in this study serves as a microcosm of surrounding underserved communities, it is likely that SRCC may be more common than expected in this vulnerable patient population, and that significant clinical differences may exist in presentation and outcomes of SRCC. In light of these differences, further research is needed to examine potential environmental and/or genetic risk factors or disparities which may be operational.

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Signet-Ring Cell Carcinoma of the Colon: A Case Report and Review of the Literature

Case Reports in Oncology ◽

10.1159/000441772 ◽

2015 ◽

Vol 8 (3) ◽

pp. 466-471 ◽

Cited By ~ 9

Author(s):

Peter Y. Park ◽

Teresa Goldin ◽

John Chang ◽

Maurie Markman ◽

Madappa N. Kundranda

Keyword(s):

Cell Carcinoma ◽

Early Stage ◽

Single Agent ◽

The United States ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Early Stage Disease ◽

Lower Quadrant ◽

Signet Ring ◽

Ring Cell

Background: Colorectal adenocarcinoma (CRC) is the third leading cause of death in the United States. One of the histologic subtypes of CRC is signet-ring cell carcinoma (SRCC), which has a distinct molecular and tumor biology from that of adenocarcinoma. Primary SRCC diagnosed at an early stage is very rare as most cases are detected at an advanced stage. Therefore, overall prognosis of SRCC is poor. Case Presentation: A 36-year-old female presented to her primary care physician with new-onset progressive right lower quadrant pain without any significant past medical or family history. Computed tomography scan of the abdomen and pelvis with contrast showed a 4.9 × 3.5 × 3.1 cm, lobulated, septated cystic mass arising from the cecum. The mass demonstrated wall enhancement and contained focal areas of coarse calcification. There was nodal involvement either locally or distally. The patient underwent right hemicolectomy, and pathology revealed a high-grade mucinous carcinoma with signet-ring cell variant invading through the muscularis propria and into the subserosal adipose tissue. The margins were negative for tumor, and no lymphovascular or perineural invasion was noted. None of the 14 resected pericolonic lymph nodes was positive for malignancy. Hence, she was staged as pT3, pN0, pMx-stage IIA. The appendix was not involved. Microsatellite instability testing showed the preservation of MLH1, PMS2, MSH2 and MSH6 proteins by IHC and PCR. Carcinoembryonic antigen level was within normal limits. Due to the patient's young age, aggressive histology and microsatellite-stable status, adjuvant fluropyrimidine (5-FU)-based therapy with the single agent capecitabine was initiated. The patient completed 6 months of adjuvant therapy and has been disease free for approximately 18 months. Conclusion: Primary SRCC of the cecum is a rare disease. Given the poor prognosis of these patients, early-stage disease with microsatellite-stable patients should be considered for adjuvant 5-FU-based therapy in an attempt to prevent recurrence.

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Wernicke Encephalopathy Due to Prolonged Total Parenteral Nutrition in A Child with Signet Ring Cell Gastric Carcinoma

10.38092/jpa-2020-7 ◽

2020 ◽

pp. 30-33

Author(s):

Buket KARA ◽

Ayse KARTAL ◽

Mehmet ÖZTÜRK ◽

Yavuz KÖKSAL

Keyword(s):

Gastric Cancer ◽

Gastric Carcinoma ◽

Parenteral Nutrition ◽

Total Parenteral Nutrition ◽

Signet Ring Cell ◽

Diffuse Gastric Cancer ◽

Wernicke Encephalopathy ◽

Signet Ring ◽

Ring Cell

Signet ring cell gastric carcinoma is extremely rare during childhood. One of the most important problems in these patients is nutritional difficulty and impairment, and these patients are often supported by total parenteral nutrition. Herein, the authors report a case of Wernicke encephalopathy due to prolonged total parenteral nutrition in a 13-year-old girl with diffuse gastric cancer with signet ring cell.

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