Lv L, Song YH, Gao Y, Pu SQ, A ZX, Wu HF, Zhou J, Xie YC. Signet-ring cell carcinoma of the transverse colon in a 10-year-old girl: A case report. World J Gastrointest Oncol 2024; 16(12): 4746-4752 [DOI: 10.4251/wjgo.v16.i12.4746]
Corresponding Author of This Article
Yu-Cheng Xie, Chief Physician, Department of Pathology, Kunming Children’s Hospital, No. 288 Qianxing Road, Kunming 650028, Yunnan Province, China. 7151290@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Dec 15, 2024; 16(12): 4746-4752 Published online Dec 15, 2024. doi: 10.4251/wjgo.v16.i12.4746
Signet-ring cell carcinoma of the transverse colon in a 10-year-old girl: A case report
Ling Lv, Yuan-Hua Song, Yan Gao, Shuang-Qiong Pu, Zhi-Xiang A, Hong-Fang Wu, Jun Zhou, Yu-Cheng Xie
Ling Lv, Yan Gao, Shuang-Qiong Pu, Zhi-Xiang A, Hong-Fang Wu, Jun Zhou, Yu-Cheng Xie, Department of Pathology, Kunming Children’s Hospital, Kunming 650028, Yunnan Province, China
Yuan-Hua Song, Department of Oncology, Kunming Children’s Hospital, Kunming 650028, Yunnan Province, China
Co-first authors: Ling Lv and Yuan-Hua Song.
Co-corresponding authors: Jun Zhou and Yu-Cheng Xie.
Author contributions: Xie YC and Zhou J designed the study and critically revised the manuscript; Lv L collected and organized pathological data, reviewed the literature and contributed to manuscript drafting; Song YH provided clinical data, revised the manuscript and was responsible for patient communication; Gao Y and Pu SQ made the diagnosis; A ZX conducted the immunohistochemistry staining; Wu HF conducted the HE staining; Lv L and Song YH contributed equally to this work as co-first authors; Zhou J and Xie YC confirm the authenticity of all the raw data as co-corresponding authors; and all authors read and approved the final manuscript.
Supported bythe Health Research Project of Kunming Municipal Health Commission, China, No. 2023-01-04-001.
Informed consent statement: Informed written consent was obtained from the patient’s parents for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: August 5, 2024 Revised: September 29, 2024 Accepted: October 18, 2024 Published online: December 15, 2024 Processing time: 99 Days and 3.9 Hours
Abstract
BACKGROUND
Signet-ring cell carcinoma (SRCC) is a rare subtype of colorectal cancer. The incidence of primary colonic SRCC is relatively rare in pediatric patients, with a limited number of reported cases currently available. The prognosis for this specific tumor type is unfavorable, and the preoperative diagnosis presents challenges, potentially leading to misdiagnosis. This case report describes the diagnosis of primary SRCC in the colon of a 10-year-old girl.
CASE SUMMARY
The patient was admitted to the hospital due to abdominal pain and vomiting. A computed tomography scan revealed an irregular mass with soft tissue density in her transverse colon, showing uneven density and multiple calcifications. The patient underwent surgical resection of the affected bowel and lymph node dissection, which was confirmed by pathological examination to be SRCC infiltrating both nerves and the entire intestinal wall. Additionally, tumor thrombus formation was observed in blood vessels and lymphatic vessels, multiple cancerous nodules were found in the omentum, and metastasis to 18 of 26 mesenteric lymph nodes examined. Immunohistochemistry for mismatch repair gene protein demonstrated microsatellite stability. No mutations in KRAS, NRAS, BRAF, or PIK3CA genes were detected through molecular pathology analysis. After surgery, she received standard chemotherapy for 8 cycles without tumor progression or other abnormalities during a 12-month follow-up period.
CONCLUSION
Primary colonic SRCC is a rare malignant tumor with atypical clinical symptoms, and timely identification and intervention are crucial for improving the prognosis.
Core Tip: We present a case of primary signet-ring cell carcinoma of the colon in a 10-year-old girl. Pediatric signet-ring cell carcinoma is an exceptionally rare condition with atypical clinical symptoms, making early diagnosis challenging. The absence of specific clinical manifestations and the disease’s concealed location often result in oversight by both clinicians and parents. Therefore, when a child presents with persistent abdominal pain, unexplained intestinal obstruction, or refractory ascites, clinicians should strongly consider the possibility of a malignant tumor. Prompt abdominal computed tomography and contrast-enhanced computed tomography scans, along with colonoscopy if indicated, are essential for early detection and timely intervention.
