Signet-Ring Cutaneous Metastasis Presenting with Huge Bunches of Grapes

Abstract

Signet-ring cell (SRC) is a histologic type in which cells show unique features under the microscope. We mainly found signet-ring cells (SRCs) in gastrointestinal and breast tumors. Cutaneous metastasis from internal carcinomas was an uncommon presentation. The cases of signet-ring cell carcinoma (SRCC) metastasis to the skin were rarely reported. Cutaneous metastasis indicated a poor prognosis for a patient. Here, we report a female who had huge grape-like nodules arising from gastrointestinal SRCC in her trunk and thigh.

Keywords:

• signet-ring cutaneous metastasis
• SRCC
• signet-ring cell carcinoma
• unknown primary tumors
• gastrointestinal tumors

Abbreviations

CA, carbohydrate antigen; CDX 2, caudal type homeobox 2; CEA, carcinoembryonic antigen; CK, cytokeratin; CYFRA 21-1, cytokeratin 19 fragment 21-1; EBUS-TBNA, endobronchial ultrasound-guided transbronchial needle aspiration; ER, estrogen receptor; FDG, fluorodeoxyglucose; GCDFP-15, gross cystic disease fluid protein-15; LDH, lactic dehydrogenase; PET/CT, positron emission tomography/computed tomography; ProGRP, pro-gastrin-releasing peptide; SRC, signet-ring cell; SRCC, signet-ring cell carcinoma; SRCs, signet-ring cells; TTF-1, thyroid transcription factor −1; β-HCG, β-Human chorionic gonadotropin.

Ethics and Consent Statement

All patient samples and clinical data using were approved by the Ethics committee of The Affiliated Hospital of Southwest Medical University. Written informed consent for publication of the case was provided by the patient’s husband for the publication of all patient’s images, samples, and clinical data.

Acknowledgments

We would like to acknowledge the patient and her families. Zhenyu Hao and Yongqiong Deng are co-first authors for this study.

Disclosure

The authors report no conflicts of interest in this work.