Primary Signet Ring Cell Carcinoma of the Pancreas with a Good Response to Chemotherapy: Case Report and Literature Review

Abstract

Significant tumor downsizing in our patient clearly demonstrates good response to neoadjuvant gemcitabine monotherapy. The optimal preoperative chemotherapy leading to tumor reduction and disease control in patients with borderline resectable and locally advanced pancreatic carcinoma is controversial, necessitating further randomized studies including combined chemoradiotherapy and multidrug combination regimens.

Primary signet ring cell carcinoma of the pancreatic head: A case report

“…These tumors can be seen on CT scan of the abdomen as a discrete hyperdense (as in our case) or hypodense lesion in the pancreas . Case reports describe findings on CT which range from showing no significant changesto identification of a diffuse tissue mass involving the pancreas . Sakai T. et al reported a case of pancreatic SRCC detected as main pancreatic duct dilation, found primarily in the pancreatic body, with multiple mural nodules identified on CT scan …”

“…From available case reports in the literature, the age at diagnosis of pancreatic SRCC ranged from 61 to 88 years. Mausam Patel et al, in their population‐based study, reported the mean age to be 66.6 years.…”

“…The presentation of pancreatic SRCC may be delayed, whereby the tumor has spread to surrounding structures making it unresectable at the time of initial diagnostic evaluation. Radojkovic et al reported the case of a borderline resectable tumor on presentation of a 67‐year‐old female patient. In Nauta et al’s report, a 71‐year‐old male patient had an unresectable tumor because of invasion around the portal vein.…”

Long-Term Survival by Resection and Adjuvant Chemotherapy With S-1 in Pancreatic Signet Ring Cell Carcinoma: a Case Report With Literature Review

“…According to the study using the Surveillance, Epidemiology, and End Results database from 2000 to 2014, the incidence of pancreatic SRCC is 0.4-0.5% among all cases of pancreatic carcinoma [1]. Among the eight cases reported thus far (Table 1) [4][5][6][7][8][9][10][11], surgical treatment with radical resection, pancreatoduodenectomy, and/or total pancreatomy could be performed in four cases, and there was only one case of borderline-resectable tumor treated with neoadjuvant chemotherapy with gemcitabine.…”

Primary signet ring cell carcinoma of the pancreas: Cytopathology review of a rare entity

“…FNA of PSRCCP has been reported to show abundant inflammatory cells, sometimes misleading the pathologists towards the diagnosis of pancreatitis, and sometimes delaying the definitive diagnosis until postmortem examination . Thus some authors suggest performing a core needle biopsy of the pancreatic mass with high suspicion for malignancy, if multiple attempts of FNA repeatedly yielded negative results …”