Early-Onset Signet-Ring Cell Adenocarcinoma of the Colon: A Case Report and Review of the Literature

Signet cell rectal carcinoma with prostatic involvement detected by FAPI-04 PET-MRI fusion

A 60-year-old male patient diagnosed with mucinous adenocarcinoma of lower third of rectum underwent abdominoperineal resection and permanent colostomy followed by adjuvant chemotherapy. Response evaluation with F-18 FDG PET-CT showed a complete metabolic response. After 6 months, CEA levels started increasing and clinically a recurrence was suspected. A restaging FDG PET-CT showed no obvious malignant disease. Patient presented again within a month with complaints of urinary retention and haematuria. CEA levels were further elevated, and Ga-68 FAPI-04 (FAPI) PET-CT was performed. FAPI PET-CT revealed prostatic and seminal vesicle disease involvement. Additionally, an MRI of pelvis was done and fused with FAPI PET for confirmation of prostatic involvement.

Early-onset colorectal cancer: Current insights and future directions

Early-onset colorectal cancer (EOCRC) has seen an alarming rise worldwide over the past two decades. The reason for this global trend is poorly understood. EOCRC appears to have its own unique clinical and molecular features when compared with late-onset colorectal cancer. Younger patients appear to have more distal or rectal disease, a more advanced stage of disease at presentation, and more unfavorable histological features. Identifying risk factors for EOCRC is the first step in mitigating the rising burden of this disease. Here we summarize several noteworthy biological factors and environmental exposures that are postulated to be responsible culprits. This can hopefully translate in clinical practice to the development of better risk stratification tool for identifying high-risk individuals for early colorectal cancer screening, and identifying areas needed for further research to curb this rising trend.

Signet-Ring Cell Colon Cancer in a Teenager: A Case Report

The majority of colon cancers are diagnosed in the older population, though recent trends have demonstrated an increase in younger patients. Most colon cancers are considered adenocarcinoma. There are multiple histologic subtypes with varying prognoses. Mucinous types such as signet-ring cell carcinoma (SRCC) are more aggressive with poor outcomes. SRCC frequently presents with metastatic disease which contributes to its poor prognosis. It is most commonly diagnosed around age 40. SRCC of colonic origin is very rare and comprises only 1% of colorectal cancers. Rarer still is presentation in the teenaged patient, especially in the absence of any risk factors. We present a case of an 18-year-old male with colonic SRCC. The patient presented initially with vague abdominal discomfort and three weeks later was found to have a near-obstructing right-sided colon mass. He was taken to the operating room and found to have diffuse carcinomatosis. The patient underwent palliative loop ileostomy with plans for subsequent chemotherapy.

Mucinous Colorectal Carcinoma in a 17-Year-Old Male: A Diagnosis with Low Clinical Index of Suspicion

Colorectal carcinoma (CRC) is commonly found in adults. CRC in the pediatric population is extremely rare. Usually, CRC is diagnosed in children at advanced stage due to a low clinical index of suspicion. Mucinous type of CRC and its signet ring variant are the most common histological types which carry very poor clinical outcomes. This paper reports a 17-year-old male who presented with mild pallor and a 3-month history of abdominal pain accompanied with a mass on the left lower quadrant, and it was then confirmed histologically to be mucinous CRC of signet ring variant. This paper will help to raise awareness among the physicians and pediatricians in including CRC in the preliminary workouts for the purpose of shortening the delay for diagnosis which in turn would compromise the prognosis of the patients.

Signet Ring Cell Carcinoma of the Colon in Young Adults: A Case Report and Literature Review

Colorectal cancer (CRC), one of the leading causes of cancer-related deaths, presents with challenging features related to its diagnosis and management. The incidence of CRC in the adolescent and young adult (AYA) population has increased over the past couple of decades despite the decline in the overall occurrence of CRC in the general population. Signet ring cell carcinoma is one of the rare histopathologic subtypes of CRC; however, it is more prevalent in AYA patients than in older adults and presents with unconventional histologic characteristics, a distinct clinical behavior, and a poor prognosis. We report a case of a primary signet ring cell adenocarcinoma of the ascending colon in a 19-year-old male who presented with unusual signs and symptoms and was diagnosed with stage IVA (T4a N0 M1, with peritoneal seeding). The unusual presentation and location of the tumor in this case warrant further investigation.

Right-colon mucinous adenocarcinoma mimicking a hydatid cyst

Hydatid disease is a fecal-oral transmission zoonosis which is endemically distributed among Mediterranean countries such as Morocco. It usually presents asymptomatically and a diagnosis is made due to cyst complications. It is most frequently located in the liver and lungs and forms large masses. The incidence of colon cancer has increased amongst population under 50 years of age during the last few decades. It has been proposed that young adult cases may have histological characteristics with a more aggressive clinical behavior. These patients are frequently diagnosed in advanced stages and a mucinous histology is frequently detected. Diagnosis is usually delayed due to a low clinical suspicion and the attribution of symptoms to other diseases such as irritable bowel and parasitosis, among others.