A Signet Cell Carcinoma of the Ileum: A Rare Differential Diagnosis of Intestinal Pathology with Fistula Mimicking Crohn’s Disease
  • Gaurav Mohan
    Monmouth Medical Center, Long Branch, NJ, USA
  • Harshil Fichadiya
    Monmouth Medical Center, Long Branch, NJ, USA
  • Darby Olex-Memoli
    Rutgers Robert Wood Johnson Medical School, Brunswick, NJ, USA
  • Divya Krishna
    Rutgers Robert Wood Johnson Medical School, Brunswick, NJ, USA
  • Doatrang Du
    Monmouth Medical Center, Long Branch, NJ, USA
  • Buket Bagchi
    Monmouth Medical Center, Long Branch, NJ, USA
  • Ali Rashidbaigi
    Monmouth Medical Center, Long Branch, NJ, USA

Keywords

Colon cancer, signet cell carcinoma, Crohn’s disease

Abstract

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.

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References

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    Published: 2022-04-07
    Issue: 2022: Vol 9 No 4 (view)

    How to cite:
    1.
    Mohan G, Fichadiya H, Olex-Memoli D, Krishna D, Du D, Bagchi B, Rashidbaigi A. A Signet Cell Carcinoma of the Ileum: A Rare Differential Diagnosis of Intestinal Pathology with Fistula Mimicking Crohn’s Disease. EJCRIM 2022;9 doi:10.12890/2022_003294.

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