A rare case of signet ring cell carcinoma of the appendix.

Primary appendiceal carcinoma itself comprises less than 0.5% of all gastrointestinal malignant neoplasms. However, signet ring cell carcinoma of the appendix is an extremely rare subset of primary appendiceal carcinomas. This sub-type of appendiceal carcinoma represents only 4% of all appendiceal carcinomas. In this case report, we present a case of signet ring cell carcinoma found in a 65-year-old male patient which presented as acute appendicitis. He was diagnosed after a laparoscopic appendectomy by histopathological evaluation.

Significance of papillary lesions at percutaneous breast biopsy.

BACKGROUND: The management of nonpalpable papillary lesions found in specimens obtained by percutaneous breast biopsy is controversial. We reviewed the treatment of patients found to have papillary lesions by stereotactic, sonographic, or fine-needle aspiration breast biopsy to identify indications for surgical excision. METHODS: Consecutive patients with intraductal papilloma, atypical papilloma/papilloma with atypical ductal hyperplasia, papillary neoplasm, and papillomatosis according to percutaneous breast biopsy were identified from radiology records. The charts were reviewed to identify patients who had subsequent surgical excision, and the pathologic findings were correlated with the biopsy method and indications for surgery. RESULTS: Papillary lesions were found in 120 biopsy samples from 109 patients. Malignancy was found at operation in 19 (24%) of 80 lesions that underwent surgical excision: 12 (63%) were ductal carcinoma-in-situ, 4 (21%) were infiltrating ductal carcinoma, 2 (11%) were infiltrating papillary carcinoma, and 1 (5%) was intracystic papillary carcinoma. Malignancy was found in 9 (30%) of 30 fine-needle biopsy papillary lesions, 6 (35%) of 17 core biopsy papillary lesions, and 4 (12%) of 33 stereotactic biopsy papillary lesions. Malignancy was missed significantly less frequently with stereotactic biopsy (P<.05). CONCLUSIONS: Malignancy is frequently found at surgical excision for papillary lesions found on percutaneous breast biopsy. Malignancy is missed significantly less frequently with stereotactic biopsy.