Hindawi Publishing Corporation Case Reports in Oncological Medicine Volume 2013, Article ID 695450, 4 pages http://dx.doi.org/10.1155/2013/695450 Case Report Signet Cell Carcinoma of Colon in a Nineteen-Year-Old Patient: A Case Report Özgül Pamukçu, 1 Fatih Selcukbiricik, 2 Ahmet Bilici, 2 Damlanur SakJz, 3 Osman ÖzdoLan, 4 and Fatih Borlu 1 1 Department of Internal Medicine, S ¸is ¸li Etfal Training Hospital, 34360 Istanbul, Turkey 2 Department of Medical Oncology, S ¸is ¸li Etfal Training Hospital, 34360 Istanbul, Turkey 3 Department of Pathology, S ¸is ¸li Etfal Training Hospital, 34360 Istanbul, Turkey 4 Department of Gastroenterohepatology, S ¸is ¸li Etfal Training Hospital, 34360 Istanbul, Turkey Correspondence should be addressed to ¨ Ozg¨ ul Pamukc ¸u; pamgul@hotmail.com Received 11 December 2012; Accepted 4 January 2013 Academic Editors: S. B. Chichareon and K. Tanaka Copyright © 2013 ¨ Ozg¨ ul Pamukc ¸u et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Signet cell carcinoma, which is a subtype of adenocarcinoma, usually originates from the stomach. However, it can also originate from the colon, rectum, gallbladder, pancreas, urinary bladder, and breast. We represent a 19-year-old boy diagnosed with signet cell tumour while he was being evaluated for an initial diagnosis of inlammatory bowel disease. 1. Introduction Globally, CRC is the third most commonly diagnosed cancer in males and the second in females, with over 1.2 million new cases and 608,700 deaths estimated to have occurred in 2008 [1]. According to the World Health Organization data, about 608.000 deaths from colorectal cancer are estimated worldwide, accounting for 8% of all cancer deaths, making it the fourth most common cause of death from cancer [2]. Colorectal cancer is a common malignancy in adults which peaks around 6th or 7th decades of life. However, less than 20% of the colorectal cancer cases can be seen before the age of 50 [3]. And in USA it was reported that less than 1% of all cancers are colorectal cancers in the irst two decades of life [4, 5]. While signet cell carcinoma is a poor diferentiated type of adenocarcinoma and behaves more aggresively than ordinary adenocarcinoma of colon, it is more common in younger patients (especially under 40) compared to other types [6]. Because of the lack of awareness at early age and the aggressive characteristic of the tumour, signet ring cell car- cinomas of the colon mostly present as advanced stage. In this case report, we report a 19-year-old boy who we were evaluating for an initial diagnosis of inlammatory bowel disease was our irst diagnosis. We have interned patient with that initial diagnosis. 2. Case A 21-year-old boy who has been evaluated in emergency service with abdominal pain was referred to our outpatient clinic because of the reason that there was seen edema and inlammation around the ileal wall and some collection regarding the initial diagnosis of inlammatory bowel disease in the CT scan performed to exclude acute abdomen. he patient has no family history of any cancer. In his physical examination, mildtenderness has been detected in the right lower quadrant and periumblical site of the abdomen. His bowel sounds were normal and in his rectal examination, there was a formed stool without blood. In his laboratory results, pathological results were as follows: CRP: 25; ESR: 22 and fecal occult blood test was positive. In his CT/CT enterography there was seen free subhepatic and pelvic abdominal luid; asimetric thickening in the sigmoid colon walls; derangement of bowels and peritoneum. According to these indings the radiologists pointed that it must be evaluated not only for inlammatory bowel disease but also