Primary signet-ring cell carcinoma of vermiform appendix: a rare case report

Qadir Fatima, Naseem A. Bihari, Kailash C. Jat


Appendiceal primary signet ring cell carcinoma is an extremely rare neoplasm considered to be more aggressive than other appendiceal tumour. Primary appendiceal carcinoma is diagnosed in only 0.9%–1.4% of appendectomy specimens and signet-ring cell carcinoma (SRCC) of vermiform appendix is accounting 0.43% of all appendiceal malignancies. Patients of SRCC usually present clinically as acute appendicitis. Preoperative imaging detection of appendiceal adenocarcinoma have limited benefit due it has minimal change like appendicitis or wall thickening without any obvious growth. We reported an extremely rare case of primary signet ring cell carcinoma of the vermiform appendix in a 55 year old man. Patient had abdominal pain, anorexia and nausea. He underwent appendectomy for appendicitis and histopathologically diagnosed as appendiceal signet ring cell carcinoma with lymph node metastasis.


Signet ring cell carcinoma, Appendix, Intestine, SRCC.

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McCuster ME, Cote TR, Clegg LX, Sobin LH. Primary malignant neoplasms of the appendix: a population-based study from the surveillance, epidemiology and end-results program, 1973–1998. Cancer. 2002;94:3307-12.

O’Donnell ME, Badger SA, Beattie GC, Carson J, Garstin WI. Malignant neoplasms of the appendix. Int J Colorectal Dis. 2007;22: 1239-48.

Carr NJ, Sobin LH. Adenocarcinoma of appendix. In: Bosman FT, Car neiro F, Hruban RH, Theise ND, eds. WHO Classification of tumours of the digestive system. Lyon: IARC. 2010:122-5.

Park IJ, Yu CS, Kim HC, Kim JC. Clinical features and prognostic factors in primary adenocarcinoma of the appendix. Korean J Gastroenterol. 2004;43:29-34.

McGory ML, Maggard MA, Kang H, O'Connell JB, Ko CY. Malignancies of the appendix: beyond case series reports. Dis Colon Rectum. 2005;48:2264-71.

Nitecki SS, Wolff BG, Schlinkert R, Sarr MG. The natural history of surgically treated primary adenocarcinoma of the appendix. Ann Surg. 1994;219:51-7.

Hartley JE, Drew PJ, Qureshi A, MacDonald A, Monson JRT. Primary adenocarcinoma of the appendix. Journal of the Royal Society of Medicine. 1996;89(2):111–3.

Murphy EM, Farquharson SM, Moran BJ. Management of an unexpected appendiceal neoplasm. Br J Surg. 2006;93:783-92.