{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T05:51:56Z","timestamp":1776664316734,"version":"3.51.2"},"reference-count":74,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Appendiceal signet-ring cell carcinoma (SRCC) is rarely encountered, and presentation with diffuse uterine involvement as the initial manifestation has not been systematically reported, posing significant risk of misdiagnosis as primary uterine malignancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 45-year-old woman presented with vaginal bleeding for 4 months. Preoperative CT demonstrated diffuse uterine myometrial thickening and appendiceal wall thickening. Curettage pathology revealed signet-ring cells with immunohistochemistry CK20+++\/SATB-2+++\/CK7-\/PAX-8-, favoring gastrointestinal origin. Intraoperatively, the uterus was 16-week size with a firm, enlarged appendix and right ovarian involvement. Cytoreductive surgery (CRS) confirmed appendiceal SRCC with uterine and mesenteric metastases. Eight cycles of adjuvant 5-FU plus cisplatin were administered. First recurrence occurred at 32 months, treated with six cycles of 5-FU, carboplatin, and bevacizumab. At last follow-up (January 2026), overall survival exceeded 52 months with normalized tumor markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For patients with \u201cuterine enlargement and ascites,\u201d appendiceal SRCC should be suspected. The enteric immunophenotype and right-sided ovarian dissemination pattern are diagnostic keys. Thorough surgery combined with chemotherapy can achieve long-term survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1833728","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T05:23:15Z","timestamp":1776662595000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Signet-ring cell carcinoma of the appendix presenting as diffuse uterine involvement: a case report and literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Kaige","family":"Pei","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junhan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, 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