This is an example of Goblet Cell Carcinoid (GCC), Group C (Adenocarcinoma ex GCC, Poorly-Differentiated Type). In such cases, typical GCC foci (Group A) are present at least focally along with poorly-differentiated or un-differentiated adenocarcinoma. The typical GCC component is seen in the left half of this image. Signet ring cell areas in the right half represent the high-grade component. Almost all Group C cases present with metastases at the time of the initial diagnosis. Metastases are usually to right colon and ileum, omentum, peritoneum, and ovaries (Krukenberg tumors). Treatment usually involves right hemicolectomy, with or without additional debulking procedures. This is usually followed by chemotherapy with regimens similar to those for colo-rectal adenocarcinomas. The overall disease-specific survival is a dismal 15% in group C cases. In contrast, the survival rates for group A and B are 96% and 73% respectively (Tang et al. Am J Surg Pathol 2008; 32:1429-1443).