Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2015; 3(6): 538-541
Published online Jun 16, 2015. doi: 10.12998/wjcc.v3.i6.538
Primary signet ring cell carcinoma of the appendix: A rare case report
Ram V Kulkarni, Sachin B Ingle, Saleha Siddiqui
Ram V Kulkarni, Sachin B Ingle, Saleha Siddiqui, Department of Pathology, MIMSR Medical College, Latur, Maharashtra 4132512, India
Author contributions: Kulkarni RV and Siddiqui S prepared the manuscript; Ingle SB critically revised the intellectual content and gave final approval of manuscript.
Ethics approval: The work done and contributions of all authors is original and ethical. The review board appreciates their work and permits them to publish their work in indexed medical journal for global readers.
Conflict-of-interest: None to be declared.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Sachin B Ingle, Professor, Department of Pathology, MIMSR Medical College, Ambajogai Road, vishwanathpuram, Maharashtra 4132512, India.
Telephone: +91-2382-227424 Fax: +91-2382-228939
Received: October 26, 2014
Peer-review started: October 27, 2014
First decision: January 20, 2015
Revised: February 3, 2015
Accepted: March 16, 2015
Article in press: March 18, 2015
Published online: June 16, 2015

Primary adenocarcinoma of the appendix is a rare malignancythat constitutes < 0.5% of all gastrointestinalneoplasms. Moreover, primary signet ring cell carcinomaof the appendix is an exceedingly rare entity. In the present report, we describe a rare case of primary signet ring cell carcinoma of the appendix with ovarian metastasesand unresectable peritoneal dissemination occurring in a 45-year-old female patient. She was clinically misdiagnosed as torsion of ovarian cyst. She underwent appendicectomy and unilateral salpingo-oophorectomy.Histopathology revealed signet ring cell carcinoma and a right hemicolectomy was done. She then received palliative systemic chemotherapy with 12 cycles of oxaliplatin, 5-fluorouracil, and leucovorin (FOLFOX-4). The patient is doing well till today on follow up without progression of disease 10 mo after beginning chemotherapy.

Keywords: Appendix, Primary, Signet ring cell carcinoma, Ovarian metastasis

Core tip: Meticulous histopathological evaluation along with clinical correlation is strongly recommended in such unusual circumstances. The clinician and surgical pathologist should keep in mind this rare entity as a differential diagnosis.