{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T07:56:51Z","timestamp":1774511811578,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Signet ring cell carcinoma (SRCC) of the rectum is a rare histologic subtype and is often associated with aggressive behavior and poor outcomes, particularly in young patients. We report a 19\u2010year\u2010old male who presented with acute intestinal obstruction and was diagnosed with rectal SRCC, radiologically staged as cT2N1bM0, acknowledging the limitations of radiologic staging in this histologic subtype. An emergency diversion colostomy was performed, followed by long\u2010course neoadjuvant chemoradiotherapy (nCRT). Three months later, the patient presented again with abdominal pain and cachexia. Radiology showed evidence of extensive peritoneal disease. Exploratory surgery revealed diffuse peritoneal carcinomatosis, preventing the planned complete cytoreduction and hyperthermic intraperitoneal chemotherapy. Further treatment options were discarded by the family. The disease progressed rapidly, and the patient passed away one month later. This case highlights the challenges in early\u2010onset rectal SRCC. The aggressive clinical course even after long\u2010course neoadjuvant chemoradiotherapy, the limitations of current treatment protocols, and the high risk of understaging through conventional radiology are highlighted in this case report.<\/jats:p>","DOI":"10.1002\/ccr3.72322","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T16:44:41Z","timestamp":1773765881000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Case Illustrating Challenges: Early\u2010Onset Signet Ring Cell Rectal Carcinoma With Fulminant Peritoneal Progression"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5063-6563","authenticated-orcid":false,"given":"Shivraj","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5020-5130","authenticated-orcid":false,"given":"Madhav Raj","family":"Karki","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9142-9661","authenticated-orcid":false,"given":"Aron","family":"Neupane","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9963-7481","authenticated-orcid":false,"given":"Shristi","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9549-9435","authenticated-orcid":false,"given":"Dikshya","family":"Pokhrel","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1524-4491","authenticated-orcid":false,"given":"Kshitiz","family":"Parajuli","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/GH9.0000000000000030"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.14740\/gr1516"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v16.i3.598"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.06.034"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-016-2224-2"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/GH9.0000000000000502"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v8.i12.819"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.897218"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23784"},{"issue":"1","key":"e_1_2_11_11_1","first-page":"72","article-title":"Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Colorectal Cancer: Survival Outcomes and Patient Selection","volume":"7","author":"Esquivel J.","year":"2016","journal-title":"Journal of Gastrointestinal Oncology"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3393\/ac.2021.00920.0131"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2023.09.053"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.9738\/INTSURG-D-14-00067.1"},{"issue":"3","key":"e_1_2_11_15_1","first-page":"1156","article-title":"Signet Ring Cell Component Predicts the Response to Neoadjuvant Chemoradiotherapy in Rectal Cancer. Long Interim Results of a Single Institution Experience","volume":"12","author":"Attia A. M.","year":"2022","journal-title":"American Journal of Cancer Research"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72322","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72322","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72322","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T06:08:06Z","timestamp":1774505286000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72322"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/ccr3.72322"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72322","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-12-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72322"}}