Metastatic Signet Ring Cell Adenocarcinoma—An Autopsy Finding in Myocardium: A Rare Case Report

Abstract Introduction  Stomach is the most common primary site of signet ring cell adenocarcinoma unlike breast or pancreas. The distant metastasis is commonly seen in peritoneum, liver, and lungs. Few cases have been reported on metastasis in pericardial fluid with presentation of cardiac tamponade. However, to the best of my knowledge, myocardium is one of the rarest sites of distant metastasis. Case Report A 26-year-old male had abdominal pain at home and was brought dead to the hospital. The postmortem examination was done, and heart was sent for histopathological report. The gross examination of heart, lungs, liver, kidneys, and spleen were unremarkable and on microscopy, sections examined from lung and left ventricular wall showed infiltration by a tumor composed of signet ring cells and few glands in the background of the mucinous material and the primary site of tumor was suggested to be stomach and rectum, whereas sections examined from liver, kidneys and spleen did not show any significant pathological change or any metastatic deposit. Conclusion Distant metastasis of signet ring cell carcinoma is mostly seen in peritoneum, liver, and lungs. So, to conclude myocardium is the rarest site of distant metastasis. Therefore, the heart autopsy is of utmost importance to look for the cause of death and also important from the perspective of academic value.