Exploring signet-ring cells in pregnant female

Area of Science:

• Gastroenterology
• Oncology
• Obstetrics and Gynecology

Background:

• Primary signet-ring cell carcinoma (SRCC) of the colon and rectum is a rare malignancy.
• SRCC typically presents at advanced stages with a poor prognosis.
• The incidence of SRCC in pregnancy is estimated to be less than 0.1%.

Purpose of the Study:

• To explore different treatment policies for SRCC during pregnancy based on gestational age.
• To highlight the importance of early diagnosis and management of colorectal cancer in pregnant patients.

Main Methods:

• A case study of a 26-year-old pregnant female (10-week gestation) presenting with constipation and rectal bleeding.
• Diagnostic workup included magnetic resonance imaging (MRI) and biopsy, revealing poorly differentiated adenocarcinoma with signet ring morphology.
• The patient underwent medical termination of pregnancy (MTP) following diagnosis.

Main Results:

• SRCC of the colon accounts for approximately 1% of all colon cancers.
• Patients with SRCC are often younger and have a higher likelihood of lymph node metastasis compared to other adenocarcinomas.
• The case highlights the diagnostic challenges and treatment considerations for colorectal cancer during pregnancy.

Conclusions:

• Any pregnant patient with rectal bleeding requires thorough evaluation to exclude colorectal cancer.
• Treatment strategies for colorectal cancer in pregnancy are complex and depend on gestational age, tumor stage, and urgency of management.
• Prompt diagnosis and tailored management are essential for improving outcomes in pregnant patients with SRCC.