Primary prostatic signet ring cell carcinoma in elderly with obstructive uropathy: a case report

Abstract

Background Primary signet-ring cell carcinoma (SRCC) of the prostate is a rare and aggressive subtype of prostate adenocarcinoma with a poor prognosis, with only approximately 60 cases reported worldwide. Case presentation A 62-year-old man presented with acute urinary retention and hematuria, after a year’s history of lower urinary tract symptoms. Digital rectal examination revealed an irregular and hard prostate. Flexible cystoscopy showed bladder base infiltration by the enlarged prostate obscuring both ureteric orifices, necessitating nephrostomy and subsequent bilateral antegrade stenting to relieve the obstruction and improve his renal function. Transrectal ultrasonography biopsy of the prostate was performed revealing histological features of SRCC. Due to its rarity, there is currently no standardized treatment approach and it is often similarly treated according to the traditional management of prostate adenocarcinoma. Conclusions SRCC of the prostate is a rare and aggressive subtype of acinar adenocarcinoma with no established guidelines. Histological criteria for SRCC of the prostate are highly variable in the available literature. It is important to differentiate between the primary and metastatic SRCC of the prostate as both are managed differently. However, the overall prognosis remains poor in general.

A Case of Prostatic Signet-Ring Cell-like Carcinoma with Pagetoid Spread and Intraductal Carcinoma and Long-Term Survival: PD-L1 and Mismatch Repair System Proteins (MMR) Immunohistochemical Evaluation with Systematic Literature Review

“…SRCC of the prostate is a vanishingly rare entity; to our knowledge, around 200 cases have been reported in the English literature. Patient age ranges from 50 to 85 years, with a median age of around 68 years [ 5 ]. Clinically, at the time of diagnosis, most patients (around 75%) have locally advanced or metastatic disease [ 9 , 37 ].…”

“…SRCC was first reported in 1981. Around 200 cases have been described in the English literature since then [ 2 , 3 , 4 , 5 ]. Histologically, the signet ring morphology of the tumor cells is characterized by an intracytoplasmic vacuole that compresses the nucleus into a crescent shape, displacing it to the cell periphery [ 6 , 7 ].…”