Mohan Gaurav, Fichadiya Harshil, Olex-Memoli Darby, Krishna Divya, Du Doantrang, Bagchi Buket, Rashidbaigi Ali
Monmouth Medical Center, Long Branch, NJ, USA.
Rutgers Robert Wood Johnson Medical School, Brunswick, NJ, USA.
Eur J Case Rep Intern Med. 2022 Apr 7;9(4):003294. doi: 10.12890/2022_003294. eCollection 2022.
Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer-related death in the USA. Primary signet ring cell carcinoma (SRCC) of the colon and rectum is extremely rare with a reported incidence of less than 1%. Here we present the case of a 41-year-old man who presented with abdominal pain, severe microcytic anaemia and a negative faecal occult blood test (FOBT). A CT scan of the abdomen revealed thickening of the terminal ileum and proximal right colon with extensive lymphadenopathy and a fistula tract extending from the terminal ileum to the right buttock. Endoscopic features like cobblestoning of the ileocolic junction along with elevated blood and stool inflammatory markers raised suspicion of Crohn's disease (CD). However, histopathological study surprisingly revealed primary colorectal signet cell carcinoma (PCRSCC) with no evidence of CD. Cases of simultaneous PCRSCC and CD have been reported, but no clear association has been established. Our case is unique in that it presented with classic clinical features of CD, but PCRSCC without any histological evidence of underlying CD was found on histology.
A rare case of primary colorectal signet cell carcinoma of the colon is described.Primary signet cell carcinoma of the colon can present with severe microcytic anaemia and abdominal pain.Signet cell carcinoma can mimic Crohn's disease on radiological and endoscopic findings, including the presence of a fistula tract.
结直肠癌（CRC）是美国第三大常见癌症，也是癌症相关死亡的第四大常见原因。结肠和直肠原发性印戒细胞癌（SRCC）极为罕见，报告发病率低于1%。在此，我们报告一例41岁男性病例，该患者表现为腹痛、严重小细胞贫血且粪便潜血试验（FOBT）阴性。腹部CT扫描显示回肠末端和右半结肠近端增厚，伴有广泛淋巴结肿大以及一条从回肠末端延伸至右臀部的瘘管。回结肠交界处鹅卵石样改变等内镜特征以及血液和粪便炎症标志物升高引发了对克罗恩病（CD）的怀疑。然而，组织病理学研究令人惊讶地发现为原发性结直肠印戒细胞癌（PCRSCC），无CD证据。同时存在PCRSCC和CD的病例已有报道，但尚未确立明确关联。我们的病例独特之处在于，它表现出CD的典型临床特征，但组织学检查发现为PCRSCC，且无任何潜在CD的组织学证据。
描述了一例罕见的结肠原发性结直肠印戒细胞癌病例。结肠原发性印戒细胞癌可表现为严重小细胞贫血和腹痛。印戒细胞癌在放射学和内镜检查结果上可模仿克罗恩病，包括存在瘘管。
