Ileal Signet Ring Adenocarcinoma in Crohn’s Disease: Unanticipated Diagnosis After Surgical Resection of a Symptomatic Stricture

Abstract

We describe a rare case of small bowel signet ring adenocarcinoma that developed in the context of ileal Crohn’s disease. The patient had medically refractory, stricturing disease for several years, leading to obstructive symptoms necessitating resection, which ultimately led to the diagnosis. This case highlights the importance of considering malignancy in the differential and surgical referral earlier in the treatment paradigm for obstructive symptoms that do not respond to IBD-directed therapies. Since there currently are no screening guidelines for small bowel malignancy in CD, close clinical monitoring is recommended in an effort to reduce complications.