Signet Ring Cell Neuroendocrine Tumor

A 63 years old woman with history of diabetes and hypertension, presented for bone pain. Pelvic X Ray showed multiple osteoconsensant lesions of the iliac wings, the sacrum and the femurs (figure 1). CT scan objectified multiple hepatic metastases with a laterorectal mass (figure 2). Colonoscopy showed aspect of extrinsic compression. Endoscopic ultrasound objectified a rectal mucosal lesion of 5x3,5 centimeters appearing in contact with the prostate (figure 3). Histologically, hepatic biopsy confirmed a tumor proliferation that was made of two architectural aspects independent cells, and trabeculolobular classical endocrine architecture with expression of synaptophysin on immunochemistry