[A case of primary signet ring cell carcinoma in urinary bladder]

A case of primary signet ring cell carcinoma in the urinary bladder in a 50-year-old male is described. The patient with a complaint of urinary incontinence was admitted for invasive bladder carcinoma based on cystoscopic examination. The pathological specimen using transurethral resection-biopsy revealed signet ring cell carcinoma. In the preoperative work up, no obvious metastases were found. Following hospitalization, the patient's course gradually worsened with weight-loss, abdominal fullness and dysuria. The operation for total cystectomy was started, but was interrupted when the peritoneal cavity was found to be fully occupied with massive ascites, invasive lesions into nets and surrounding tissue. He died on November 19, 1986, approximately 7 months after onset of symptoms. An autopsy proved that the tumor which was pathologically identified as signet ring cell carcinoma, originated from the urinary bladder invading the perivesical tissues, and also into the intraabdominal space. We found 34 cases in the literature, originating from the urinary bladder. This case is considered to be the 35th. In conclusion, rapid total cystectomy following an early and definite diagnosis is the only procedure to treat such tumors.