• Neoplasms
• Prostate cancer
• Prostatectomy
• Prostatic diseases
• Prostatic neoplasms
• and serous
• cystic
• mucinous

• Humans
• Male
• Carcinoma, Signet Ring Cell/therapy
• Carcinoma, Signet Ring Cell/pathology
• Carcinoma, Signet Ring Cell/diagnosis
• Prostatic Neoplasms/therapy
• Prostatic Neoplasms/pathology
• Prostatic Neoplasms/diagnosis
• Prostatic Neoplasms/mortality
• Aged
• Prognosis
• Middle Aged
• Prostate-Specific Antigen/blood
• Prostatectomy

• Case report
• Colon
• Pathological presentation
• Pediatric
• Signet ring cell cancer

• Case report
• Concentric wall infiltration
• Magnetic resonance imaging
• Metastatic spread
• Prostatic adenocarcinoma
• Rectal linitis plastica
• Signet ring cell carcinoma

• Colorectal Neoplasms
• Histology
• Morphological and Microscopic Findings

• Humans
• Colorectal Neoplasms/pathology
• Adenocarcinoma/pathology
• Prognosis

• features of mucin
• prostate cancer
• signet-ring cell-like carcinoma

• Humans
• Male
• Middle Aged
• Prostatic Neoplasms/pathology
• Prostatic Neoplasms/diagnosis
• Carcinoma, Signet Ring Cell/diagnosis
• Carcinoma, Signet Ring Cell/pathology
• Mucins/analysis
• Adenocarcinoma/diagnosis
• Fatal Outcome

• Colorectal cancer
• Poorly cohesive cells
• Prognosis
• Risk factors
• Signet-ring cell histology
• Systematic review
• Therapeutic management

• Colorectal cancer
• LODDS
• Lymph node stage
• Nomogram
• SEER database
• Signet ring cell carcinoma

• Humans
• Nomograms
• Calibration
• Carcinoma, Signet Ring Cell
• Colorectal Neoplasms
• Databases, Factual
• Prognosis
• Lymph Nodes

• Clinical characteristic
• Gastrointestinal
• Molecular characteristic
• Signet ring cell carcinoma
• Treatment

• Humans
• Gastrointestinal Neoplasms/therapy
• Adenocarcinoma
• Carcinoma, Signet Ring Cell/diagnosis
• Carcinoma, Signet Ring Cell/pathology
• Biomarkers

• colorectal cancer
• nomogram
• seer database
• signet ring cell carcinoma
• survival

• Humans
• Nomograms
• Research
• Calibration
• Carcinoma, Signet Ring Cell/surgery
• Colorectal Neoplasms/surgery
• SEER Program

• Nomogram
• PSM
• Primary mixed adeno-neuroendocrine carcinoma
• Primary signet-ring cell cancer
• Prognosis
• SEER

• 2017Y9038, 2019Y9101 Joint Funds for the innovation of Science and Technology
• 2020GGB022 Fujian Provincial Health Technology Project
• 2022J01753 Natural Science Foundation of Fujian Province

• appendiceal cancer
• colorectal cancer
• peritoneal metastases
• signet ring cells

• No specific number Bengt Ihre Research Fellowship
• No specific number Makarna Eriksson's fund at Uppsala University Hospital
• No specific number Lion's research fund in Uppsala
• 21 1719 Pj to TS and 22 2054 Pj 01H to BG Swedish Cancer Society

Colorectal signet ring cell carcinoma (SRCC) is a rare and distinct subtype of colorectal cancer (CRC), with extremely poor prognosis and aggressive tumor biological behavior. In this study, we aimed to analyze the clinicopathological characteristics and to identify the independent predictors of long-time survivors (LTSs) of nonmetastatic colorectal SRCC.

Patients diagnosed with nonmetastatic colorectal SRCC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We compared and analyzed the clinicopathological characteristics between LTSs (patients survived over 5 years) and non-LTSs (patients survived of or less than 5 years). Afterwards, multivariate logistic regression analysis was used to identify independent predictors of LTSs, which were further used to construct a nomogram model to predict the probability of being LTSs.

We enrolled 2050 patients with nonmetastatic colorectal SRCC, consisting of 1441 non-LTSs and 609 LTSs. Multivariate logistic regression analysis revealed that race, marital status, tumor infiltration, lymph node involvement, and primary tumor treatment were independent predictors of LTSs. In addition, these five parameters were incorporated into a nomogram model to predict the probability of being LTSs. In terms of the model performance, the calibration curve revealed good agreement between observed and predicted probability of LTSs, and receiving operator characteristic curve showed acceptable discriminative capacity in the training and validation cohorts.

Collectively, we analyzed and profiled the clinicopathological characteristics of LTSs in patients with nonmetastatic colorectal SRCC. Race, marital status, T stage, N stage, and primary tumor treatment were independent predictors of LTSs.

A 54‐year‐old man had previously undergone curative sigmoidectomy for poorly differentiated adenocarcinoma with a signet‐ring cell component of the sigmoid colon, which was characterized morphologically by stenosis and inelasticity of the colon (linitis plastica). Six weeks after surgery, the patient developed stenosis of the right ureter. Disseminated sigmoid cancer was suspected, and chemotherapy was started. Nine months after initiation of chemotherapy, obstructive jaundice was observed which was due to stenosis of the distal bile duct (BD). Although computed tomography showed no evident metastatic lesion that could cause the stenosis, swelling of the entire pancreas was evident compared to that of 11 months earlier. Endoscopic ultrasound (EUS) also did not detect any focal masses in the head of the pancreas, although there was a diffuse hypoechoic change in the entire pancreas. Histopathology of the stenotic BD and biopsy specimen from the head of the pancreas showed no malignant cells. Two months after the initial endoscopic bile duct drainage, the patient was admitted again for epigastric pain. A second EUS fine needle aspiration (EUS‐FNA) of the head of the pancreas was performed and showed poorly differentiated carcinoma with some signet‐ring cells. This finding provided histological confirmation of a disseminated pancreatic lesion of the previously resected linitis plastica of the sigmoid colon. This is a rare case of disseminated pancreatic lesion from primary linitis plastica of the colon diagnosed by EUS‐FNA.

• Case report
• Colorectal cancer
• Signet ring cell carcinoma
• Ulcerative colitis

Signet ring cell carcinoma of the rectum is rare and typically presents with advanced disease. We report a case of a 68-year-old man who presented with left lower quadrant pain and was found to have signet ring cell carcinoma with intussusception. This case is unusual because of its polypoid growth pattern and apparent early pathological stage. We discuss the differential diagnoses and prognosis.

Colorectal signet ring cell carcinoma (SRCC) is a rare subtype of colorectal cancer (CRC) with unique characteristics. Due to the limited researches on it, a comprehensive and in-depth understanding of this subtype is still lacking. In this article, we summarize the clinicopathological features and molecular characteristics of colorectal SRCC based on a literature review. Clinically, SRCC has been associated with young age, proximal site preference, advanced tumor stage, high histological grade, high rate of lymph node involvement, frequent peritoneal metastasis, and a significantly poor prognosis. Regarding molecular characteristics, in SRCC, the mutation burden of the classic signaling pathways that include WNT/β-catenin, RAS/RAF/MAPK, and PI3K/AKT/mTOR signaling pathways are generally reduced. In contrast, some genes related to the “epithelial-mesenchymal transition (EMT) process” and the “stem cell properties”, including RNF43, CDH1, and SMAD4, as well as the related TGF-β signaling pathway have been observed more frequently altered in SRCC than in conventional adenocarcinoma (AC). In many studies but not in others, SRCC showed a higher frequency of BRAF mutation, microsatellite instability-high (MSI-H) and CpG island methylator phenotype (CIMP) positive status compared to AC. It has been proposed that colorectal SRCC consists of two subtypes, in which the MSI⁺/CIMP⁺/BRAF⁺/CD3⁺/PD-L1⁺ hypermethylated genotype is more common in the proximal colon, and may represent the potential candidate for immunotherapy. Understanding the special molecular mechanisms related to the aggressive biology of SRCC is of great importance, which may provide a theoretical basis for the development of more targeted and effective treatments for this refractory disease.

• clinicopathology
• colorectal cancer
• molecular features
• review
• signet ring cell carcinoma

The prognostic role of marital status on colorectal signet ring cell carcinoma (SRCC) has not been studied. In this study, the correlation of marital status with prognosis of colorectal SRCC was analyzed. Eligible subjects were extracted from the Surveillance, Epidemiology, and End Results (SEER) dataset from 2004 to 2015, followed by comparison of cancer-specific survival (CSS) and overall survival (OS) between married and unmarried group. 3152 patients were identified including 1777 married patients (56.38%). Married populations tended to be more patients aged < 65, male, receiving chemotherapy, and less black race and large tumor size compared to unmarried group (all P < 0.05).Moreover, 5-year CSS (30.04% vs. 28.19%, P = 0.0013) and OS rates (26.68% vs. 22.94%, P < 0.0001) were superior in married population. Multivariate analysis revealed that marital status was an independent favorable prognostic indicator, and married population had better CSS (HR: 0.898; 95% CI: 0.822–0.980; P = 0.016) and OS (HR: 0.898; 95%CI: 0.827–0.975; P = 0.011).In addition, CSS as well as OS were superior in married populations than unmarried ones in most subgroups. Marital status was an independent prognostic factor for survival in patients with colorectal SRCC. Additionally, married patients obtained better survival advantages.

This study aimed to explore the association of tumor sidedness with the prognosis of patients with colon signet ring cell carcinoma (SRCC). Eligible patients were retrieved from the Surveillance, Epidemiology, and End Results database between 2004 and 2015. Cancer-specific survival (CSS) and overall survival (OS) were compared between patients with left-sided colon SRCC and those with right-sided lesions. A total of 2660 patients were included, among them, 1983 (74.5%) had right-sided colon SRCC. Compared to patients with left-sided colon SRCC, those who had the right-sided colon SRCC showed higher proportion of white race, female, aged ≥ 65 years, receiving total colectomy and ≥ 4 regional lymph node dissection; while had lower proportion of advanced AJCC stage. Besides, right-sided patients exhibited superior 5-year CSS (32.74% vs. 25.89%, P = 0.001) and OS (27.38% vs. 23.02%, P = 0.024) rates compared with left-sided ones. Multivariate analysis revealed that tumor sidedness was an independent prognostic factor. To be specific, patients with right-sided colon SRCC showed better CSS (HR: 0.873; 95% CI 0.777–0.981; P = 0.023) and OS (HR: 0.838; 95% CI 0.753–0.965; P = 0.002). Moreover, subgroup analysis demonstrated superior CSS and OS for right-sided patients in most subgroups. Tumor sidedness was an independent prognostic indicator for colon SRCC. Besides, patients with right-sided colon SRCC have superior prognosis than those with left-sided lesions.

• Diagnostic criteria
• Malignant polyp
• Prognostic factors
• Risk stratification

• Adenocarcinoma
• Colonoscopy
• Colorectal carcinoma
• Mucin
• Undiagnosed cancer

We aimed to reveal clinicopathological features and explore survival-related factors of colorectal signet ring cell carcinoma (SRCC). A population-based study was carried out to investigate colorectal SRCC by using data extracted from the surveillance, epidemiology and end results (SEER) database between 2004 and 2015. In total, 3,278 patients with colorectal SRCC were identified, with a median age of 63 (12–103) years old. The lesions of most patients (60.49%) were located in the cecum–transverse colon. In addition, 81.27% patients had advanced clinical stage (stage III/IV), and 76.69% patients had high pathological grade. The 3–, 5–year cancer‐specific survival and overall survival rate was 35.76%, 29.32% and 32.32%, 25.14%. Multivariate analysis revealed that primary site in cecum–transverse colon, married, received surgery, lymph node dissections ≥ 4 regional lymph nodes were independent favorable prognostic. Meanwhile, aged ≥ 65 years, higher grade, tumor size ˃5 cm and advanced AJCC stage were associated with poor prognosis. Patient age, tumor grade, marital status, tumor size, primary tumor location, AJCC stage, surgery and number of dissected lymph node had significant correlation with prognosis of colorectal SRCC.

• primary signet ring cell carcinoma with adenoma
• radical resection
• rectum

• Adenocarcinoma/diagnosis
• Adenocarcinoma/pathology
• Carcinoma, Signet Ring Cell/diagnosis
• Carcinoma, Signet Ring Cell/pathology
• Humans
• Male
• Mass Screening/methods
• Middle Aged
• Rectal Neoplasms/diagnosis
• Rectal Neoplasms/pathology
• Rectum/pathology
• Treatment Outcome

Signet ring cell adenocarcinomas (SRCCs) are a rare histological subtype of adenocarcinomas with a poor prognosis, typically due to advanced disease at diagnosis. A signet ring cell, mimicking its moniker, contains abundant intracytoplasmic mucin that pushes the nucleus to the periphery. In these cancers, this cell feature comprises more than 50% of the tumor. Despite predilection for the gastrointestinal tract, and in particular the stomach, primary SRCCs are also described in other sites, typically in case reports. This literature, however, lacks a standardized overview of the SRCC disease entity. Using a retrospective cohort approach, we summarize the clinicodemographic and mortality outcomes of SRCCs in thirteen primary sites, comprising 95% of all SRCCs in the Surveillance, Epidemiology, and End Results Program (SEER), a population-level cancer database covering nearly one-third of the United States population. SRCCs general trends compared to matching nonvariant adenocarcinomas are earlier age of onset, with initial presentation favoring higher rates of regional or distant disease presentation and poor tumor differentiation. After multivariable analysis, SRCCs typically have worse overall survivals, but substantial variances exist depending on tumor location. Identifying SRCCs at earlier disease stages is likely the single most important intervention to improving outcomes for these patients.

• CDH1
• E-cadherin
• cancer
• chemotherapy
• diffuse type
• histopathology
• radiotherapy
• surgery

• Colorectal cancer
• Signet ring cell carcinoma
• Ulcerative colitis

The objective of this research was to validate the diagnostic value of three-dimensional texture parameters and clinical characteristics in the differentiation of colorectal signet-ring cell carcinoma (SRCC) and adenocarcinoma (AC).

We retrospectively analyzed data from 102 patients with SRCC or AC confirmed by pathology, including 51 SRCC (from January 2015 to July 2019) and 51 AC patients (from January 2019 to July 2019). CT findings and clinical data, including age, gender, clinical symptoms, serological biomarkers, tumor size, and tumor location, were compared between SRCC and AC. CT texture features were quantified on portal phase images using three-dimensional analysis. A list of texture parameters was generated with MaZda software for the classification of tumors. The texture features, clinical data and CT findings were statistically analyzed for the discrimination ability of SRCC and AC, and the potential predictive parameters that may be used to differentiate the two groups were subsequently tested using the least absolute shrinkage and selection operator (LASSO) and logistic regression analyses. The receiver operating characteristic curve (ROC) provided a range of values for establishing the cutoff value, as well as the sensitivity and specificity of prediction for each significant variable.

SRCC occurred more often in men than AC did (80.39% vs 49.02%, P < 0.01). The patients were younger in the SRCC group than in the AC group, without a statistically significant difference (55.84 vs 59.20 years, P = 0.216). There were no significant differences in the clinical symptoms, tumor size, or tumor location between the two groups (P=0.505, P=0.19, P=0.843, respectively). The elevation of serological biomarker CA724 was more common in SRCC than in AC (P< 0.001). Perc.01%3D, Perc.10%3D and s(1,0,0) SumAverg were lower in the SRCC group than in the AC group during the portal phase, with the areas under curve (AUCs) of 0.892–0.929, sensitivity of 76.5–84.3% and specificity of 88.2–96.1%. In the differentiation between SRCC and AC, the 1-NN minimal classification error (MCR) was 29.41%.

Three-dimensional texture parameters, including Perc.01%3D, Perc.10%3D and s(1,0,0) SumAverg, exhibited a favorable discriminatory ability to distinguish SRCC from AC.

• adenocarcinoma
• colorectal signet-ring cell carcinoma
• computed tomography
• texture analysis
• three-dimensional

• adenocarcinoma with osseous metaplasia
• clear cell carcinoma
• colorectal cancer histotypes
• cribriform/comedo-type carcinoma
• hepatoid carcinoma
• lymphoepitelioma-like carcinoma
• medullary carcinoma
• micropapillary carcinoma
• rhabdoid carcinoma
• signet ring cell carcinoma

Colorectal signet ring cell carcinoma (SRCC) is a rare histological subtype of colorectal adenocarcinoma with high metastatic frequency compared to non‐SRCC colorectal cancer (NOS). The aim of this study was to analyze prognostic factors of colorectal SRCC with different metastatic sites and evaluate impacts of various therapies for metastatic colorectal SRCC.

Patients with NOS and SRCC were from the Surveillance, Epidemiology, and End Results (SEER) database during 2010‐2014. χ² tests were used to compare data significance. Kaplan‐Meier and COX models were used to analyze the differences in the survival. Propensity‐matched analyses were used to adjust numerical differences.

Among the 173 460 patients, 1932 (1.11%) patients had colorectal SRCC. In univariate analysis, older age, male sex, and peritoneum metastasis were associated with higher mortality risk. The peritoneum was both the site with the highest metastatic frequency and the site with the worst prognosis in SRCC. In the COX regression model, peritoneum‐metastatic SRCC patients receiving chemotherapy had better survival than patients treated with surgery.

Our study analyzed the unique metastatic pattern of colorectal SRCC toward different sites and found that compared to surgery, chemotherapy was associated with better survival for colorectal SRCC patients with distant metastasis, which provided insights for future SRCC patient treatment.

• SEER database
• chemotherapy
• peritoneum metastasis
• signet ring cell carcinoma
• surgery

We report here a rare case of adult sacrococcygeal teratoma (SCT) that was pathologically diagnosed as signet ring cell carcinoma (SRCC). A 26-year-old man complained of lower abdominal distension and discomfort and difficulty in urinating, and he was admitted to our hospital. Pelvic magnetic resonance imaging showed multiple oval, solid-cystic masses around the anterior sacrococcygeal region that measured approximately 96 × 114 × 89 mm. Magnetic resonance imaging also showed irregular cysts around the posterior sacrococcygeal region that measured approximately 34 × 72 × 60 mm. The preliminary diagnosis was cystic SCT. The patient then underwent surgery, during which we incised the cysts. A large amount of viscous, jelly-like liquid was present in the anterior sacrococcygeal mass. Furthermore, a large amount of light yellow, porridge-like secretion was present in the posterior sacrococcygeal mass. A pathological examination and immunohistochemistry confirmed teratoma, specifically SRCC.

• Sacrococcygeal teratoma
• carcinoembryonic antigen
• cyst
• magnetic resonance imaging
• mucinous adenocarcinoma
• signet ring cell carcinoma
• tumor

Linitis plastica is a rare condition showing circumferentially infiltrating intramural anaplastic carcinoma in a hollow viscus, resulting in a tissue thickening of the involved organ as constricted, inelastic, and rigid. While most secondary rectal linitis plastica (RLP) is caused by metastasis from stomach, breast, gallbladder, or bladder cancer, we report an extremely rare and unique case of secondary RLP due to prostate cancer with computed tomography (CT) and magnetic resonance imaging (MRI) findings, including diffusion weighted imaging (DWI). A 78-year-old man presented with approximately a 2-mo history of constipation and without cancer history. On sigmoidoscopy, there was a luminal narrowing and thickening of rectum with mucosa being grossly normal in its appearance. On contrast-enhanced CT, marked contrast enhancement with wall thickening of rectum was noted. On pelvic MRI, rectal wall thickening showed a target sign on both T2-weighted imaging and DWI. A diffuse infiltrative lesion was suspected in the prostate gland based on low signal intensity on T2-weighted imaging and restricted diffusion. A transanal full-thickness excisional biopsy revealed metastasis from a prostate adenocarcinoma invading the submucosa to the muscularis propria consistent with metastatic RLP. We would like to emphasize the CT and MRI findings of metastatic RLP due to prostate cancer.

• Prostate cancer
• Linitis plastica
• Magnetic resonance imaging
• Rectum
• Metastasis

• Carcinoma
• Colorectal
• Mucinous adenocarcinoma
• Signet ring cell
• Survival

• Adenocarcinoma, Mucinous/secondary
• Adenocarcinoma, Mucinous/surgery
• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Signet Ring Cell/secondary
• Carcinoma, Signet Ring Cell/surgery
• Colonic Neoplasms/pathology
• Colonic Neoplasms/surgery
• Female
• Follow-Up Studies
• Humans
• Lymphatic Metastasis
• Male
• Middle Aged
• Neoplasm Invasiveness
• Neoplasm Recurrence, Local/pathology
• Neoplasm Recurrence, Local/surgery
• Prognosis
• Rectal Neoplasms/pathology
• Rectal Neoplasms/surgery
• Retrospective Studies
• Survival Rate

The aim of this study is to evaluate the prognosis for patients with a signet-ring-cell carcinoma (SRCC) who undergo curative surgery by comparing them to patients with an adenocarcinoma (ADC), excluding a mucinous ADC.

Between September 1994 and December 2013, 14,110 patients with colorectal cancer underwent surgery and among them, 12,631 patients were enrolled in this study. 71 patients with a SRCC and 12,570 patients with a ADC were identified. We analyzed the disease-free survival and the overall survival rates before and after a 1:2 propensity score matching and evaluated those rates after stage stratification.

The median follow-up durations were 48.5 months for the SRC group and 48.6 months for the ADC group. The disease-free survival rates and the overall survival rates were significantly lower in the SRC group before and after propensity score matching (P < 0.001). After stratification by stage, no differences were observed between the SRC and the ADC groups for the disease-free survival (DFS) and the overall survival (OS) rates for patients with cancer in its early stages (P = 0.913 and P = 0.380 for the DFS and the OS, respectively, in stages 0 and I, and P = 0.223 and P = 0.991 for the DFS and the OS, respectively, in stage II), but those rates were significantly lower in the SRC group for cancer in its later stages (P < 0.001, respectively in stages III and IV).

For cancer in advanced stages, patients with a resectable colorectal SRCC had a poorer prognosis after propensity score matching than those with an ADC did. Therefore, more intensive surveillance and closer observation should be offered to such patients.

• Adenocarcinoma
• Colorectum
• Prognosis
• Signet-ring cell
• Stage

• Clinicopathologic features
• Colorectal cancer
• Metastases
• Signet-ring cell carcinoma
• Survival

Most colorectal cancers are classical adenocarcinomas (AC), and less frequent subtypes include mucinous adenocarcinomas (MAC) and signet-ring cell carcinomas (SC). The purpose of this study was to evaluate the computed tomography (CT) findings that can help to differentiate MAC and SC from AC.

CT scans of 168 patients with pathologically proven MAC and 67 patients with pathologically proven SC were analyzed, and 220 patients with classical AC were also included as a control group. CT findings of the three groups were compared and contrasted in terms of the bowel involvement patterns, contrast enhancement patterns, and presence or absence of bowel obstruction, intratumoral calcification, pericolic fat infiltration, and local tumor extension to adjacent organs. Statistical analyses were made by using the one-way analysis of variance, least significant difference test, and Pearson’s chi-square test.

Compared with classical AC, the MAC showed more severe (6.29±2.69 cm vs 4.57±1.74 cm, P<0.001) and higher percentage of occurrence of eccentric bowel-wall thickening (37.2% vs 11.5%, P<0.001). Heterogeneous contrast enhancement was most common in MAC (P<0.01), and MAC showed more areas with hypoattenuation (P<0.001). The presence of intratumoral calcification was most frequent in MAC (17.9% vs 2% vs 6.8%) (P<0.001); the SC also were more severe (5.75±2.28 cm vs 4.57±1.74 cm. P=0.001) than AC, but SC tend to show more cases of concentric even bowel-wall thickening (67.2%); homogeneous contrast enhancement was most common in SC (P<0.01), and it showed a target appearance. The presence of peritoneal seeding was most frequent in SC (35.8% vs 8% vs 2.7%, P<0.001), while the presence of regional lymph node metastasis (P=0.190) and direct invasion of adjacent organs or metastasis (P=0.323) were not significantly different among them.

Some radiological features by CT can be used to classify different colon tumor types.

• cancer
• colorectal
• computed tomography
• mucinous
• prognosis
• signet ring

• SEER
• invalid operations
• metastatic colorectal cancer (mCRC)
• signet ring cell carcinoma (SRCC)
• survival

Signet ring cell carcinoma (SRCC) is rare. The aim of this study is to understand the clinicopathological features and identify the possible prognostic factors in colorectal SRCC.

Patients with SRCC who underwent primary lesion resection at Fudan University Shanghai Cancer Center from September 2008 to July 2014 were retrospectively analyzed. Patient’s gender, age, tumor location, depth of invasion, lymph node metastasis, synchronous distant metastasis, perineural invasion, lymphovascular invasion, and E-cadherin expression were studied with prognosis, and the correlation between E-cadherin expression and clinicopathological features were analyzed. All clinicopathological and molecular factors were put into multivariate analysis using Cox proportional hazards model for detecting independent prognostic factors.

59 patients accounting for 0.89% of total colorectal cancer patients met the criteria and were enrolled in the study. The median survival time is 28.9 months, and the 3-year survival rate is 62.7%. SRCC were seen more common in young male patients. Advanced stage was more common in SRCC, 58 (98.3%) patients had T3/T4 lesions, 52 (88.1%) patients had lymph node metastasis, and 14 (23.7%) patients had distant metastasis. Distant metastases were seen more common in peritoneal cavity. Distant metastasis (HR = 4.194, 95% CI: 1.297–13.567), lymphovascular invasion (HR = 2.888, 95% CI: 1.115–7.483), and E-cadherin expression (HR = 0.272, 95% CI: 0.096–0.768) were independent predictors for survival.

SRCC is a rare subtype of colorectal cancer with poor prognosis. Distant metastasis, lymphovascular invasion, and E-cadherin expression can predict prognosis of colorectal SRCCs independently. More precise therapy and more close surveillance are needed for these patients.

• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Cadherins/metabolism
• Carcinoma, Signet Ring Cell/metabolism
• Carcinoma, Signet Ring Cell/mortality
• Carcinoma, Signet Ring Cell/pathology
• Colorectal Neoplasms/metabolism
• Colorectal Neoplasms/mortality
• Colorectal Neoplasms/pathology
• Female
• Humans
• Immunohistochemistry
• Lymphatic Metastasis
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Staging
• Prognosis
• Proportional Hazards Models
• Retrospective Studies
• Sex Factors
• Survival Rate
• Young Adult

• National Natural Science Foundation of China
• Science and Technology Commission of Shanghai Municipality

• Colorectal adenocarcinoma
• KRAS
• Molecular profiling
• Preneoplastic lesions
• Signet ring cell carcinoma

• Adenoma/chemistry
• Adenoma/genetics
• Adenoma/pathology
• Adenoma/surgery
• Aged
• Biomarkers, Tumor/analysis
• Biomarkers, Tumor/genetics
• Carcinoma, Signet Ring Cell/chemistry
• Carcinoma, Signet Ring Cell/genetics
• Carcinoma, Signet Ring Cell/pathology
• Carcinoma, Signet Ring Cell/surgery
• Cell Dedifferentiation
• Colectomy
• Colonic Neoplasms/chemistry
• Colonic Neoplasms/genetics
• Colonic Neoplasms/pathology
• Colonic Neoplasms/surgery
• DNA Mutational Analysis
• Disease Progression
• Genetic Predisposition to Disease
• Humans
• Immunohistochemistry
• Male
• Mutation
• Phenotype
• Proto-Oncogene Proteins p21(ras)/genetics
• Tumor Suppressor Protein p53/analysis

• Colorectal cancer
• Molecular biology
• Pathology
• Signet ring cell
• Treatment

Case series

Patient: Male, 59 • Male, 85 • Male, 27

Final Diagnosis: refractory metastatic rectal cancer

Symptoms: —

Medication: —

Clinical Procedure: Chemotherapy

Specialty: Oncology

• Carcinoma, Signet Ring Cell/pathology
• Carcinoma, Signet Ring Cell/surgery
• Chemotherapy, Adjuvant
• Colectomy/methods
• Colostomy/methods
• Follow-Up Studies
• Humans
• Male
• Monitoring, Physiologic/methods
• Neoplasm Invasiveness/pathology
• Neoplasm Staging
• Proctoscopy/methods
• Rectal Neoplasms/pathology
• Rectal Neoplasms/surgery
• Risk Assessment
• Tomography, X-Ray Computed/methods
• Treatment Outcome
• Young Adult

• Signet-ring cell carcinoma (SRCC)
• colorectal cancer
• pregnancy
• signet-ring cells

The incidence of intussusception is low in adults, particularly in the descending colon, due to the anatomical attachment of the descending colon to the retroperitoneum. Signet ring cell histology represents ~1% of colon adenocarcinomas and is associated with young patients and a poor clinical outcome. The present study describes a case of descending colo-colonic intussusception caused by signet ring cell carcinoma in a 27-year-old male. The patient presented with a history of intermittent left upper-quadrant abdominal pain for more than six months without any evident etiology. A computed tomography scan of the abdomen revealed left-sided colo-colonic intussusception. Upon laparotomy, a left hemicolectomy was performed according to intraoperative frozen-section pathology. Post-operative pathological evaluation revealed signet ring cell carcinoma invasion of the serosa, and 31.8% (7/22) of the regional lymph nodes were positive for cancerous cells. The post-operative course was uneventful and the patient was discharged on the tenth post-operative day.

• adult intussusception
• descending colon cancer
• signet ring cell carcinoma

• Colon carcinoma
• Early stage
• Endoscopic mucosal resection
• Primary carcinoma
• Signet ring cell carcinoma

• Carcinoma, Signet Ring Cell/diagnosis
• Carcinoma, Signet Ring Cell/pathology
• Carcinoma, Signet Ring Cell/surgery
• Colectomy/methods
• Colonic Neoplasms/diagnosis
• Colonic Neoplasms/pathology
• Colonic Neoplasms/surgery
• Colonoscopy
• Early Detection of Cancer
• Humans
• Male
• Middle Aged
• Neoplasm Staging
• Treatment Outcome