Signet Ring Cell Carcinoma of the Duodenal Bulb With Metastases to the Ovaries and the Colon: A Case Report

Abstract

Primary duodenal cancer is a rare entity which has accounted for only 0.3% of all gastrointestinal cancers. The majority of duodenal bulb cancers are adenocarcinomas and other histological variants are less frequent. Signet ring cell carcinoma, though more commonly found in the stomach, is uncommonly found to originate in the duodenal bulb. A review of the literature revealed only one previously reported cases of signet ring cell carcinoma of the duodenal bulb. We report a rare case of signet call carcinoma of the duodenal bulb with metastasis to the ovaries, peritoneum, and colon in a 25-year-old Hispanic female. She presented with abdominal pain, ascites, nausea and jaundice. Subsequent imaging studies revealed an adnexal mass and upper endoscopy revealed an exophytic obstructing duodenal bulb mass, biopsy consistent with signet ring carcinoma. Etiology and survival of signet ring cell carcinoma of the duodenal bulb is not well-defined in the literature due to the extreme rarity of this disease. Continued reporting of this rare entity will help in characterizing the natural history of the disease, which may allow for earlier recognition and treatment.




J Med Cases. 2013;4(5):327-329
doi: https://doi.org/10.4021/jmc1223w