A Signet Cell Carcinoma of the Ileum: A Rare Differential Diagnosis of Intestinal Pathology with Fistula Mimicking Crohn’s Disease

Colorectal cancer (CRC) is the third most common and fourth cause of cancer-related death in USA. Primary signet ring cell carcinoma (SRCC) colon rectum extremely rare with a reported incidence less than 1%. Here we present case 41-year-old man who presented abdominal pain, severe microcytic anaemia negative faecal occult blood test (FOBT). A CT scan abdomen revealed thickening terminal ileum proximal right extensive lymphadenopathy fistula tract extending from to buttock. Endoscopic features like cobblestoning ileocolic junction along elevated stool inflammatory markers raised suspicion Crohn’s disease (CD). However, histopathological study surprisingly primary colorectal (PCRSCC) no evidence CD. Cases simultaneous PCRSCC CD have been reported, but clear association has established. Our unique that it classic clinical CD, without any histological underlying was found on histology.