J Korean Soc Coloproctol.  2006 Jun;22(3):204-209.

Primary Signet-ring-cell Carcinoma of the Right and the Sigmoid Colon in Crohn's Disease

• Kim HR
• Lee IK
• Lee YS
• Park JK
• Oh ST
• Kim JG
• Lee K
• Park GS
• Jung SE
• Park SH
• Chang SK

Abstract

A 31-year-old woman with a 5-year history of Crohn's disease was admitted to our hospital because of recurrent right lower quadrant pain and diarrhea. Abdominal computed tomography showed multiple fistulas between the terminal ileum, the sigmoid colon, and the cecum, and mucosal wall thickenings due to an active inflammatory process and mucosal enhancements. Colonoscopic examinations showed a finger-like projection of a polypoid mass at the ileocecal valve, long-neck, finger-like pseudopolyps at the cecum, and soft, lumen narrowing and multiple pseudopolyps at the sigmoid colon and the intact rectum. There was healing scarring of the anal fistula. These findings were compatible with those of Crohn's disease. Histologic findings were chronic inflammation with erosion and regenerative crypt epithelium. The patient underwent infliximab therapy. She underwent a right colectomy, a Hartman's procedure, and a small bowel segmental resection due to multiple fistulas. The pathologic diagnosis was a signet-ring-cell carcinoma with non-caseating granuloma in the ascending colon, ileum, and sigmoid colon. We report this case of Crohn's disease associated with a colonic signet-ring cell carcinoma.

Keyword

Crohn's disease; Colonic signet-ring-cell carcinoma; Infliximab

MeSH Terms

Adult
Cecum
Cicatrix
Colectomy
Colon
Colon, Ascending
Colon, Sigmoid*
Crohn Disease*
Diagnosis
Diarrhea
Epithelium
Female
Fistula
Granuloma
Humans
Ileocecal Valve
Ileum
Inflammation
Infliximab
Rectal Fistula
Rectum