Primary signet ring cell carcinoma of uterine cervix and related disease: two case reports and a review

Primary signet ring cell carcinoma of uterine cervix (SRCCC) is extremely rare. We present two cases of primary SRCCC that were treated with robot-assisted laparoscopic radical hysterectomy (RALRH). Case 1 had stage IB2 cervical adenocarcinoma, in which signet ring cell (SRC) was predominant. As adjuvant chemotherapy was not successful, she twice underwent surgical excision of recurrent tumors in pararectal lymph node and periureteral space 11 months and 27 months after RALRH, respectively. There were only SRCs observed in recurrent tumors. Case 2 had stage IB1 cervical adenocarcinoma, in which SRCs were detected only in the biopsy specimen, and no relapse occurred at 15 months after RALRH. PET/CT was useful for tumor detection in both cases, and the amount of SRC components was associated with the prognostic outcome. Considering the high recurrence rate and few complications at secondary surgery, minimally invasive surgery would be preferred as the primary surgery for SRCCC.