Signet-Ring Cell Carcinoma Presenting as Colocolic Intussusception

A 30-year-old man presented with acute onset pain abdomen and blood-stained mucoid stools of 3 days’ duration. Past history included recurrent episodes of melena and mucoid stools of 2 months’ duration with significant weight loss. A contrast-enhanced computed tomography of the abdomen revealed dilated small bowel with features of colocolic intussusception, with multiple air foci within bowel wall and decreased contrast uptake suggestive of imminent ischaemia (Figures 1-2). Intraoperatively, an intussusception of the proximal transverse colon with an overlying omental tumor measuring 4 x 5 cm was found (Figure 3). An extended right hemicolectomy and omentectomy was performed with ileocolic anastomosis. Histopathological examination of the specimen revealed features consistent with signet-ring cell carcinoma (SRCC) of the colon with omental metastasis. Postoperative upper gastrointestinal endoscopy revealed no primary tumor in the stomach. The patient was given 5-fluorouracil (450 mg/m) and