Farida Abi Farraj,1 Hadi Sabbagh,1 Tarek Aridi,1 Najla Fakhruddin,2,3 and Fadi Farhat4
1Faculty of Medicine, American University of Beirut, Beirut, Lebanon
2Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
3Department of Pathology, Hammoud Hospital University Medical Center, Saida, Lebanon
4Department of Oncology, Hammoud Hospital University Medical Center, Saida, Lebanon
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.