This paper was presented at the XXXII World Congress of the International College of Surgeons, Singapore International Convention and Exhibition Centre, Singapore, 8–12 October 2000.
Primary colorectal signet-ring cell carcinoma in Singapore
Article first published online: 20 DEC 2001
ANZ Journal of Surgery
Volume 71, Issue 12, pages 703–706, December 2001
How to Cite
Ooi, B. S., Ho, Y. H., Eu, K. W. and Seow Choen, F. (2001), Primary colorectal signet-ring cell carcinoma in Singapore. ANZ Journal of Surgery, 71: 703–706. doi: 10.1046/j.1445-1433.2001.02269.x
- Issue published online: 20 DEC 2001
- Article first published online: 20 DEC 2001
- Accepted for publication 20 July 2001.
- colorectal tumour;
- liver metastases;
- peritoneal seeding;
- signet-ring cell carcinoma
Background: Primary colorectal signet-ring cell carcinoma is a rare but distinctive tumour of the colon and rectum. The clinicopathological features are still controversial. The aim of this study is to review the clinicopathological features and management of this type of tumour in our hospital.
Methods: The clinicopathological features and survival data of all cases of primary colorectal signet-ring cell carcinoma were reviewed retrospectively.
Results: There were nine cases of primary colorectal signet-ring cell carcinoma in 3000 consecutive colorectal carcinoma patients seen from 1989 to 1999. There were seven male and two female patients with a mean age of 54.7 years. Three patients were younger than 40 years. The common presenting symptoms were rectal bleeding (33%) and small bowel obstruction (33%). Two (22%) patients required emergency surgery due to acute small bowel obstruction. The most common tumour location was the right colon (44%) followed by the rectum (33%). All nine patients presented at a very late stage of disease. A majority (77%) had Dukes’ C disease while two (22%) had Dukes’ D disease with distant dissemination. Peritoneal spread (33%) was the most frequent way of dissemination. There was no patient with liver metastases at the time of diagnosis and initial presentation. The mean survival time was 30 (range 5–108) months. The 5-year survival rate was 12%.
Conclusions: Primary colorectal signet-ring cell carcinoma is frequently diagnosed late with a very poor prognosis. A high incidence of peritoneal seeding and low incidence of liver metastases appears to be a characteristic of signet-ring cell carcinoma of the colon and rectum.