Endometrial Endometrioid Carcinomas With Signet Ring Cells: Report of a Case Series With Detailed Clinical, Pathologic, and Molecular Analysis.
Megan Ryan, Jennifer Taylor, Lauren McConnell et al.
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Case in brief
This case series described five patients aged 53–89 years who presented with postmenopausal bleeding and had endometrioid-type endometrial carcinomas containing signet ring cells. The cells comprised 10%–30% of each tumor and were confined to solid areas. Tumors spanned FIGO grades 2–3 and stages IA to IIIC1. Molecular classification identified one POLE-mutated tumor, three MMR-deficient tumors, and one p53-abnormal tumor. Four patients were alive without evidence of disease at 4–24 months; one died 7 months after diagnosis from an unrelated cause.
What made this case unusual
Signet ring cells are an uncommon morphology in primary endometrial carcinoma; in this series they occurred in endometrioid-type tumors and were confined to solid tumor areas. The authors noted a possible association with MMR deficiency, while emphasizing the small number of cases.
Diagnostic / clinical pearl
Signet ring cells can occur in primary endometrioid-type endometrial carcinoma. Their presence should be interpreted in the tumor’s morphologic and molecular context rather than assumed to indicate another primary site.
Why it matters
The tumors showed varied molecular classifications and included high-stage presentations, underscoring that this morphology alone does not define a single molecular subtype or stage.