Korean J Gastrointest Endosc.  2010 Dec;41(6):373-377.

A Case of Rectal Metastasis from Primary Signet Ring Cell Carcinoma of the Colon

Affiliations
  • 1Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea. dramc@hanmail.net
  • 2Department of Pathology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea.

Abstract

Rectal metastasis of colon cancer without peritoneal carcinomatosis is a rare condition whose initial clinical presentation may mimic inflammation. To the best of our knowledge, there was no report on such cases. A 45-year-old man with a history of left hemicolectomy and adjuvant chemotherapy for primary signet ring cell carcinoma (SRCC) of the descending colon, admitted to have constipation and abdominal pain for 3 weeks. His colonoscopic findings did not show local tumor recurrence at the anastomsis site, however, a hard, concentric luminal narrowing of the lower rectum was encountered. Endoscopic biopsies revealed chronic inflammations, and positron emission tomography with 18F-fluorodeoxyglucose revealed diffuse mildly hypermetabolic lesion in the rectum, suggesting inflammation. Magnetic resonance image showed submucosal wall thickening with multiple perirectal lymph nodes. Rectal metastasis of colon cancer was highly suspected clinically and a surgical biopsy confirmed SRCC which was surgically removed thereafter.

Keyword

Colon; Signet ring cell carcinoma; Rectum; Metastasis
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