Prostatic signet-ring adenocarcinoma: A case report

Background: Prostatic signet-ring adenocarcinoma is a rare histological variant of prostate cancer. The tumor is characterized by an aggressive clinical course. Methods: Herein we present the case of a 78-year-old man with obstructive urinary symptoms and elevated serum prostate specific antigen. Transurethral resection of the prostate was performed. Results: Histologically, a tumor that was mainly composed of signet ring cells was identified. The tumor cells were positive for alcian blue special stain. Another Gleason 4 adenocarcinoma component was identified. The patient received hormonal therapy. A favorable response was documented at 8 months of follow up. Conclusions: Ruling out another primary site of origin, such as the gastrointestinal tract, is mandatory, and a more aggressive management plan should be put in mind.

Carcinoma; Prostate; Signet ring cell

[1] Torbenson M, Dhir R, Nangia A, Becich MJ, Kapadia SB. Pro-static carcinoma with signet ring cells: a clinicopathologic and immunohistochemical analysis of 12 cases, with review of the literature. Modern Pathology. 1998; 11: 552–559.

[2] Kuroda N, Yamasaki I, Nakayama H, Tamura K, Yamamoto Y, Miyazaki E, et al. Prostatic signet-ring cell carcinoma: case re-port and literature review. Pathology International. 1999; 49: 457–461.

[3] Smith C, Feddersen RM, Dressler L, McConnell T, Milroy T, Smith AY. Signet ring cell adenocarcinoma of prostate. Urology. 1994; 43: 397–400.

[4] Celik O, Budak S, Ekin G, Akarken I, Ilbey YO. A case with primary signet ring cell adenocarcinoma of the prostate and re-view of the literature. Archivio Italiano di Urologia e Androlo-gia. 2014; 86: 148–149.

[5] Sungur M, Şentürk AB, Çalışkan S, Gürel A. Primary signet cell carcinoma of the prostate: a case report. Memo-Magazine of Eu-ropean Medical Oncology. 2017; 10: 115–117.

[6] Kim SW, Kim W, Cho Y, Kim T, Woo I, Sohn DW. Primary signet ring cell carcinoma of the prostate treated by radical cystoprostatectomy and chemoradiotherapy. Canadian Urolog-ical Association Journal. 2019; 10: E204–E206.

[7] Pinta DLC, Martin M. A case with primary signet ring cell ade-nocarcinoma of the prostate and review of the literature. Journal of Cancer Prevention & Current Research. 2017; 7: 0025.

[8] Gök A, Tuygun C, Akmansu M, Uslu AA, Kartal IG, Sandikçi F, et al. Primary signet ring cell carcinoma of the prostate: a rare case report. Journal of Clinical Medicine. 2019; 7: 218.

[9] Kwon W, Oh TH, Ahn SH, Lee JW, Park SC. Primary signet ring cell carcinoma of the prostate. Canadian Urological Association Journal. 2013; 7: E768–E771.

[10] Fujita K, Sugao H, Gotoh T, Yokomizo S, Itoh Y. Primary signet ring cell carcinoma of the prostate: report and review of 42 cases. International Journal of Urology. 2004; 11: 178–181.

[11] Singh P, Albertson D, Pal SK, Agarwal N. Mucinous, Signet Ring, Ductal, and Sarcomatoid Variants of Prostate Cancer. Rare Genitourinary Tumors. 2016; 65: 205–218.

[12] Guerin D, Hasan N, Keen CE. Signet ring cell differentia-tion in adenocarcinoma of the prostate: a study of five cases. Histopathology. 1993; 22: 367–371.

[13] Alguacil-Garcia A. Artifactual changes mimicking signet ring cell carcinoma in transurethral prostatectomy specimens. The American Journal of Surgical Pathology. 1986; 10: 795–800.

[14] Skodras G, Wang J, Kragel PJ. Primary prostatic signet-ring cell carcinoma. Urology. 1993; 42: 338–342.

[15] Warner JN, Nakamura LY, Pacelli A, Humphreys MR, Castle EP. Primary signet ring cell carcinoma of the prostate. Mayo Clinic Proceedings. 2011; 85: 1130–1136.

[16] Lilleby W, Axcrona K, Alfsen GC, Urnes T, Hole KH. Diag-nosis and treatment of primary signet-ring cell carcinoma of the prostate. Acta Oncologica. 2008; 46: 1195–1197.

[17] Akagashi K, Tanda H, Kato S, Ohnishi S, Nakajima H, Nanbu A, et al. Signet-ring cell carcinoma of the prostate effectively treated with maximal androgen blockade. International Journal of Urology. 2004; 10: 456–458.

[18] Roldán AM, Núñez NF, Grande E, García A, Antón-Aparicio LM. A Primary Signet Ring Cell Carcinoma of the Prostate with Bone Metastasis with Impressive Response to FOLFOX and Ce-tuximab. Clinical Genitourinary Cancer. 2012; 10: 199–201.