Year 2017 / Volume 109 / Number 2
Digestive Diseases Image
Signet ring cell carcinoma of the jejunum: an uncommon finding within the reach of capsule endoscopy

149-150

José Francisco Juanmartiñena, Marta Montes, Ignacio Fernández-Urién,

Abstract
An 80 year-old female presented with ductal breast carcinoma (stage II) three years ago, complained of asthenia and iron-deficiency anemia. No diagnosis was obtained after conventional endoscopy and iron supplements were indicated. Ten months later visible digestive hemorrhage was presented. Upper and lower endoscopy was repeated but non-diagnosis was obtained. Thus, video capsule endoscopy was indicated identifying a stenotic lesion arising in the mucosa of distal jejunum. Histopathological examination revealed a poorly mucinous differentiated signet-ring cell adenocarcinoma with an intense peri-tumoral lymphoid (Crohn´s–like lymphoid reaction) and lympho-vascular infiltration with no nodal metastases (pT3N0;7ª edition TNM classification). Immunochemistry revealed negative stained for estrogen and progesterone receptors in contrast with prior breast cancer. Thus, metastatic origin was rule out. Primary small-bowel malignancies are extremely rare. They account for 2% of all gastrointestinal tract malignancies. Carcinoid tumor (40%), adenocarcinoma (33%), lymphoma (17%) and sarcoma (8%) are most common histological types. Symptomatic lesions are rare, but when present: gastrointestinal bleeding, abdominal pain and weight loss are most common digestive symptoms. Primary signet ring cell adenocarcinoma is a rarely histopathological variety of adenocarcinoma with poor prognosis, usually identified in esophageal or gastric locations (95%). They are less commonly detected in remaining gastrointestinal tract, and when present, metastatic origin must always rule out. Nowadays, diagnostic delayed is common and leads to detected small bowel neoplasms at late stages with poor treatment outcomes. Thus, capsule endoscopy may help to improve this situation as it may identify them at early stages.
Share Button
New comment
Comments
No comments for this article
References
1. Bilimoria KY, Bentrem DJ, Wayne JD, et al. Small bowel cancer in the United States: changes in epidemiology, treatment, and survival over the last 20 years. Ann Surg. 2009;249:63-71
2. Iizawa H, Ikeda E, Sato T, et al. Signet-ring cell carcinoma of the ileum: report of a case and review of the Japanese literature. Surg Today.1998; 28:1168-71.
3. Yamagami H, Oshitani N, Suekane T, et al. Signet-ring cell carcinoma of the jejunum diagnosed by double balloon enteroscopy. Hepatogastroenterology. 2008; 55:1246-8.
Related articles

Letter

Gastric schwannoma diagnosing gastric stromal tumor

DOI: 10.17235/reed.2023.9919/2023

Letter

Blue rubber bleb nevus syndrome

DOI: 10.17235/reed.2023.9913/2023

Digestive Diseases Image

Enteroenteric intussusception caused by a small bowel metastatic cutaneous melanoma

DOI: 10.17235/reed.2023.9876/2023

Letter

Capsule endoscopy diagnosis of gastrointestinal melanoma

DOI: 10.17235/reed.2023.9803/2023

Letter

Pseudo-submucosal tumor in the colon: seeing is believing

DOI: 10.17235/reed.2023.9773/2023

Letter

Calcifying fibrous tumor and pathological analysis

DOI: 10.17235/reed.2023.9739/2023

Letter

Mucosal Schwann cell hamartoma: a benign and little-known entity

DOI: 10.17235/reed.2023.9652/2023

Letter

Carcinoid syndrome and somatostatin analogues

DOI: 10.17235/reed.2023.9525/2023

Letter

Isolated Jejunal Crohn's Disease: a challenging diagnosis

DOI: 10.17235/reed.2022.9423/2022

Digestive Diseases Image

Whipple’s disease – A typical endoscopic finding of a rare disease

DOI: 10.17235/reed.2022.9338/2022

Digestive Diseases Image

Germ cell tumor with duodenal involvement: a rare case of gastrointestinal bleeding

DOI: 10.17235/reed.2022.9327/2022

Letter

Colon adenocarcinoma associated with intestinal sarcoidosis

DOI: 10.17235/reed.2022.9279/2022

Letter

An unexpected gastric cardia submucosal lesion

DOI: 10.17235/reed.2022.9260/2022

Letter

A rare endoscopic finding: primary esophageal melanoma

DOI: 10.17235/reed.2022.9244/2022

Letter

Colonic malignancy: always adenocarcinomas?

DOI: 10.17235/reed.2022.9223/2022

Digestive Diseases Image

Intrabiliary metastasis of colorectal adenocarcinoma: the SPY perspective

DOI: 10.17235/reed.2022.9202/2022

Letter

GIST is not all that it seems

DOI: 10.17235/reed.2022.8974/2022

Letter

Primary intestinal melanoma?

DOI: 10.17235/reed.2022.8944/2022

Digestive Diseases Image

An unusual finding in gastroesophageal surgery: gastric anthracosis

DOI: 10.17235/reed.2022.8882/2022

Letter

Ectopic ACTH syndrome in a patient with Crohn’s disease

DOI: 10.17235/reed.2022.8825/2022

Letter

Digestive tract MALT lymphoma, an unusual location

DOI: 10.17235/reed.2022.8800/2022

Letter

Cytomegalovirus colitis seems to be colon cancer. HIV debut

DOI: 10.17235/reed.2022.8699/2022

Digestive Diseases Image

Ileal neuroendocrine tumor as an uncommon cause of obscure gastrointestinal bleeding

DOI: 10.17235/reed.2022.8641/2022

Letter

Successful endoscopic removal of a giant duodenal bulb mass

DOI: 10.17235/reed.2022.8595/2022

Digestive Diseases Image

Gastric gastrointestinal stromal tumor abscess

DOI: 10.17235/reed.2022.8580/2022

Letter

Endoscopic full-thickness resection of a gastric schwannoma

DOI: 10.17235/reed.2021.8385/2021

Letter

Gruber-Frantz tumor: a rare pancreatic neoplasm

DOI: 10.17235/reed.2021.8345/2021

Digestive Diseases Image

Endoscopic resection of a duodenal neuroendocrine tumor

DOI: 10.17235/reed.2021.8232/2021

Digestive Diseases Image

Small bowel occlusion secondary to a giant abdominal solitary fibrous tumor

DOI: 10.17235/reed.2021.8196/2021

Digestive Diseases Image

Duodenal-type follicular lymphoma: a silent tumor

DOI: 10.17235/reed.2021.8149/2021

Letter

Bochdalek hernia: use of capsule endoscopy

DOI: 10.17235/reed.2021.7760/2020

Digestive Diseases Image

Inflammatory pseudotumor-like follicular dendritic cell sarcoma of the liver

DOI: 10.17235/reed.2020.7602/2020

Digestive Diseases Image

Epithelioid hemangioendothelioma: a rare cause of a liver tumor

DOI: 10.17235/reed.2020.7127/2020

Original

Gastric plexiform fibromyxoma, an uncommon mesenchymal tumor

DOI: 10.17235/reed.2020.7048/2020

Letter

Giant pancreatic cystic lymphangioma

DOI: 10.17235/reed.2020.7003/2020

Letter

Colonic adenocarcinoma arising from traditional serrated adenoma

DOI: 10.17235/reed.2020.6818/2019

Digestive Diseases Image

Groove pancreatitis: a rare cause of severe gastric dilation

DOI: 10.17235/reed.2020.6765/2019

Digestive Diseases Image

Endoscopic submucosal dissection of colonic anisakiasis

DOI: 10.17235/reed.2020.6748/2019

Digestive Diseases Image

A rare cause of extrahepatic biliary tract stricture: a neuroendocrine carcinoma

DOI: 10.17235/reed.2020.6491/2019

Letter

Primary gastric choriocarcinoma

DOI: 10.17235/reed.2020.6478/2019

Digestive Diseases Image

Jejunal schwannoma detected by video capsule endoscopy

DOI: 10.17235/reed.2020.6474/2019

Letter

Klatskin-mimicking neuroendocrine tumor

DOI: 10.17235/reed.2019.6382/2019

Digestive Diseases Image

Capsule endoscopy, a useful tool for the diagnosis of a tapeworm infection

DOI: 10.17235/reed.2019.6346/2019

Letter

Ruptured hepatic sarcoma as a cause of acute abdomen

DOI: 10.17235/reed.2019.6163/2019

Case Report

Pancreatobiliary maljunction: association with gallbladder cancer

DOI: 10.17235/reed.2019.6127/2018

Editorial

Safe surgery for cystic tumors of the pancreas

DOI: 10.17235/reed.2019.6042/2018

Letter

Use of patency capsule in daily practice

DOI: 10.17235/reed.2019.5952/2018

Letter

A granular cell tumor: an unusual colon polyp

DOI: 10.17235/reed.2018.5918/2018

Digestive Diseases Image

Painless jaundice as an initial presentation of lung adenocarcinoma

DOI: 10.17235/reed.2018.5587/2018

Letter

Retroperitoneal schwannoma

DOI: 10.17235/reed.2018.5569/2018

Letter to the Editor

Author´s reply: Cystic pancreatic neuroendocrine tumors. A diagnostic challenge

DOI: 10.17235/reed.2018.5415/2017

Letter

Giant hepatobiliary cystadenoma: clinic-pathological findings

DOI: 10.17235/reed.2018.5414/2017

Letter to the Editor

EUS-guided ethanol ablation therapy for gastric stromal tumors

DOI: 10.17235/reed.2017.5361/2017

Digestive Diseases Image

Giant intra-abdominal liposarcoma

DOI: 10.17235/reed.2018.5176/2017

Digestive Diseases Image

Right-colon mucinous adenocarcinoma mimicking a hydatid cyst

DOI: 10.17235/reed.2017.5041/2017

Letter to the Editor

A case of a mixed adenoneuroendocrine tumor of the colon

DOI: 10.17235/reed.2017.5008/2017

Letter to the Editor

Neuroendocrine tumors of the pancreas: keys issues in dealing with heterogeneity

DOI: 10.17235/reed.2017.4997/2017

Letter to the Editor

Pancreatic neuroendocrine tumors. Prognostic factors

DOI: 10.17235/reed.2017.5109/2017

Digestive Diseases Image

Metastasis of dermatofibrosarcoma diagnosed by capsule endoscopy

DOI: 10.17235/reed.2018.4900/2017

Letter to the Editor

Chronic diarrhea, weight loss and heart failure. Features of the same disease?

DOI: 10.17235/reed.2017.4874/2017

Letter to the Editor

Pancreatic neuroendocrine tumors

DOI: 10.17235/reed.2017.4725/2016

Letter to the Editor

Symptomatic retention of the Agile® patency capsule

DOI: 10.17235/reed.2017.4691/2016

Editorial

Pancreas neuroendocrine tumors - not so rare or benign

DOI: 10.17235/reed.2016.4672/2016

Letter to the Editor

Endoscopic full-thickness resection for a gastric angioleiomyoma

DOI: 10.17235/reed.2017.4568/2016

Digestive Diseases Image

Debut of an unusual liver cirrhosis

Letter to the Editor

Ball valve syndrome caused by a giant gastric Vanek’s tumor

DOI: 10.17235/reed.2017.4526/2016

Letter to the Editor

Unusual presentation of obstructive jaundice

DOI: 10.17235/reed.2017.4501/2016

Letter to the Editor

Whipple’s disease under the vision of capsule endoscopy

DOI: 10.17235/reed.2016.4362/2016

Letter to the Editor

Asymptomatic bronchial aspiration of capsule endoscope: a significant complication

DOI: 10.17235/reed.2016.4363/2016

Letter to the Editor

Transanal submucosal endoscopic resection (TASER) by TEO system®

DOI: 10.17235/reed.2016.4154/2015

Letter to the Editor

Gastric neuroendocrine tumor presenting with gastrointestinal bleeding

DOI: 10.17235/reed.2015.3998/2015

Letter to the Editor

Surgical management of appendiceal adenocarcinoid. Case report and literature review

DOI: 10.17235/reed.2016.4049/2015

Letter to the Editor

Endoscopic submucosal dissection for a gastric fibrolipoma

DOI: 10.17235/reed.2015.3982/2015

Review

Endoscopic ampullectomy: a technical review

DOI: 10.17235/reed.2016.3867/2015

Case Report

Pelvic inflammatory myofibroblastic tumor mimicking a rectal cancer

DOI: 10.17235/reed.2015.3777/2015

Digestive Diseases Image

Sister Mary Joseph´s nodule

Case Report

Atypical diagnosis diagnosis by endoscopic capsule: Whipple´s disease

DOI: 10.17235/reed.2015.3718/2015

Case Report

Mesenteric tumor due to chronic anisakiasis

DOI: 10.17235/reed.2015.3687/2015

Letter to the Editor

Duodenal involvement by seminomatous tumors

DOI: 10.17235/reed.2015.3646/2014

Letter to the Editor

Synchronic gastric and pancreatic ductal adenocarcinoma. A case report

DOI: 10.17235/reed.2015.3720/2014

Letter to the Editor

Leiomyosarcoma of the ascending colon: a rare tumor with poor prognosis

DOI: 10.17235/reed.2015.3606/2014

Letter to the Editor

Leiomyoma of the round ligament of the liver: Report of one case

DOI: 10.17235/reed.2015.3725/2014

Citation tools
Juanmartiñena J, Montes M, Fernández-Urién I. Signet ring cell carcinoma of the jejunum: an uncommon finding within the reach of capsule endoscopy. 4346/2016


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 246 visits.
This article has been downloaded 50 times.
Publication history

Received: 29/03/2016

Accepted: 10/04/2016

Published: 31/01/2017

Article revision time: 10 days

Article editing time: 308 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology