Signet ring carcinoma of the esophagogastric junction in a Nigerian man

Globally, the majority of cancers of the esophagogastric junction are adenocarcinomas. Of the four histological subtypes, the signet ring carcinomas are rare. There is a dearth of reports of this relatively rare histological finding from patients in sub-Saharan Africa. We present such a case in 69 year old Nigerian with advanced malignant disease. Key word: Signet ring carcinoma, esophagogastric junction, endoscopy, Nigeria. INTRODUCTION Adenocarcinomas that cross the esophagogastric junction (EGJ) are called adenocarcinomas of the EGJ, regardless of where the bulk of the tumor lies (Sons et al., 1986). The World Health Organization (WHO) classification distinguishes four histological types: papillary, tubular, mucinous, and signet ring cell adenocarcinoma (Hamilton and Aaltonen, 2000). The disease appears to have a low prevalence rate in sub-Saharan Africa generally and Nigeria specifically (Kachala, 2010; Abdulkareem et al., 2008). Although, exact data about EGJ tumors is not presently available, its rarity can be inferred from other published work that investigated incidence and prevalence patterns of all esophageal and gastric cancers. A worrying increase in the incidence and prevalence of adenocarcinoma of the esophagus has been noted in Western countries (Vizcaino et al., 2002). The signet ring cell subset of adenocarcinomas is characterized by abundant intracellular mucin accumulation leading to compressed nucleus which is eccentrically located within the cell. It must be distinguished from the mucinous variety which possesses abundant extracellular mucin. For the lesion to qualify as signet ring cell carcinoma, the adenocarcinoma’s predominant component (more than 50%) must be composed of isolated malignant cells containing this