Lv Ling, Song Yuan-Hua, Gao Yan, Pu Shuang-Qiong, A Zhi-Xiang, Wu Hong-Fang, Zhou Jun, Xie Yu-Cheng
Department of Pathology, Kunming Children's Hospital, Kunming 650028, Yunnan Province, China.
Department of Oncology, Kunming Children's Hospital, Kunming 650028, Yunnan Province, China.
World J Gastrointest Oncol. 2024 Dec 15;16(12):4746-4752. doi: 10.4251/wjgo.v16.i12.4746.
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.
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 , , , or 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.
Primary colonic SRCC is a rare malignant tumor with atypical clinical symptoms, and timely identification and intervention are crucial for improving the prognosis.
印戒细胞癌（SRCC）是结直肠癌的一种罕见亚型。原发性结肠SRCC在儿科患者中发病率相对较低，目前报道的病例数量有限。这种特定肿瘤类型的预后不佳，术前诊断存在挑战，可能导致误诊。本病例报告描述了一名10岁女孩结肠原发性SRCC的诊断情况。
患者因腹痛和呕吐入院。计算机断层扫描显示其横结肠有一个软组织密度的不规则肿块，密度不均匀且有多处钙化。患者接受了受累肠段的手术切除及淋巴结清扫，病理检查证实为SRCC，侵犯神经和整个肠壁。此外，在血管和淋巴管中观察到肿瘤血栓形成，大网膜中发现多个癌结节，在检查的26个肠系膜淋巴结中有18个发生转移。错配修复基因蛋白免疫组化显示微卫星稳定。通过分子病理学分析未检测到 、 、 或 基因的突变。术后，她接受了8个周期的标准化疗，在12个月的随访期内无肿瘤进展或其他异常情况。
原发性结肠SRCC是一种罕见的恶性肿瘤，临床症状不典型，及时识别和干预对改善预后至关重要。
