International Journal of Research in Medical Sciences | June 2021 | Vol 9 | Issue 6 Page 1787 International Journal of Research in Medical Sciences Puri M et al. Int J Res Med Sci. 2021 Jun;9(6):1787-1789 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Case Report Primary signet ring carcinoma of the rectum: a rare entity Monica Puri 1 , Neha Singh 1,2 *, M. S. Bal 1 , Neelam Gupta 1 INTRODUCTION Signet ring cell carcinoma (SRCC) is a variant of mucinous carcinoma identified microscopically by tumor cells with peripherally pushed nuclei and abundant intracytoplasmic mucin. SRCC most commonly arise in the stomach but can be seen in other organs like breast, gallbladder, pancreas, urinary bladder, and colorectum. 1 Colorectal signet ring cell carcinoma is a rare histological type with an incidence rate between 0.1% and 2.6% of all primary colorectal cases reported in literature. 2,3 Signet ring cell morphology should be present in >50% tumor cells for the diagnosis. It is a clinicopathological distinct entity with respect to colorectal adenocarcinomas in terms of onset at young age, high rate of distant metastasis, lower rate of liver metastasis, increased rate of peritoneal seeding and poor prognosis. 2 Moreover, SRCC has a high tendency for intramucosal spread with relative sparing of the mucosa. Hence, tumor cells are rarely identified in some cases in regular biopsies. 4,5 Most case series report a predilection to males, with male to female ratio of 2:1, and is usually found in the right colon or the rectum. 6 We are reporting a case of SRCC of rectum in a young male in which diagnosis was made by trucut biopsy. CASE REPORT A 26 year old young male presented in surgery outpatient department (OPD) of our hospital with sudden, intermittent painless bleed per rectum following meals and significant weight loss since one year. He had no past history of similar illness. The family history was not contributory to his symptoms. General physical examination his pulse rate was 104/minute and blood pressure was 108/72 mm Hg. Patient was pale with cachexic look. Rectal examination revealed an indurated, fixed palpable growth obstructing the rectal lumen. Investigations Ultrasonography (USG) of abdomen showed a normal study. Thoracoabdominal contrast enhanced computed tomography (CECT) scan revealed few calcific granulomas in the upper and lower lobe of right lung and segment VII of liver. There was no evidence of focal mass lesion in the liver. Plain magnetic resonance imaging (MRI) of pelvis in axial and coronal planes with correlative 1 Department of Pathology, MMMC&H, Solan, Himachal Pradesh, India 2 Department of Pathology, MMIMSR, Mullana, Ambala, Haryana, India Received: 22 March 2021 Revised: 29 April 2021 Accepted: 01 May 2021 *Correspondence: Dr. Neha Singh, E-mail: drnehasingh25@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Signet ring cell carcinoma constitute an uncommon histological type of rectal cancer with less than 1% of all rectal neoplasms. It usually behaves aggressively and has an inferior prognosis. Herein, we present a rare case in young male diagnosed by trucut biopsy. Keywords: Signet ring cell carcinoma, Rectum, Rare DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20212254