Iranian Journal of Pathology

Primary Signet Ring Cell Carcinoma Bilateral Breast: An Exceptional Occurrence

Articles in Press

Document Type : Case Reports

Authors

Garima Dhull 1
Mukta Pujani 1
Varsha Chauhan 1
Aniruna Dey 1
Neha Garg 1
Neha Raghav 1
Sonali Madaan 2
Kartik Kaul 2

1 Dept. of Pathology, ESIC Medical College and Hospital, Faridabad, Haryana, India

2 Dept. of Radiodiagnosis, ESIC Medical College and Hospital, Faridabad, Haryana, India

10.30699/ijp.2026.2069045.3521
Abstract
Signet ring cell carcinoma (SRCC) of the breast is an exceptionally rare subtype accounting for only 0.04% to 2.7% of all breast cancers. Pure SRCC is characterized by the presence of >90% signet ring cells and exhibits an aggressive clinical profile often associated with higher histologic grade, lympho-vascular invasion, hormone receptor positivity, and low HER2 expression. Differentiating primary mammary SRCC from metastases from gastrointestinal primary, especially in elderly patients with bilateral presentations, is of prime importance. Immunohistochemistry plays a crucial role in this regard, with primary breast SRCCs displaying ER, GATA3, and CK7 positivity and CK20 and CDX2 negativity. We report a case of bilateral signet ring cell carcinoma of the breast in an 82-year-old female. This case highlights the significance of recognising SRCC breast as a distinct pathological entity and thorough evaluation in case of bilateral presentation, as it is exceptionally uncommon and poses diagnostic and therapeutic challenges.

Keywords

Signet Ring Cell Carcinoma, Breast, Bilateral, Primary

Subjects

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Iranian Journal of Pathology

Articles in Press, Accepted Manuscript
Available Online from 25 February 2026

  • Receive Date 27 August 2025
  • Revise Date 15 October 2025
  • Accept Date 05 February 2026

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