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He underwent neoadjuvant therapy with partial response, had surgery with curative intent and showed local recurrence after only 3\u2009months. Disease progression happened only weeks after recurrence with metastasis to vertebrae, extraocular muscles, bone marrow and skin. He is currently receiving palliative chemotherapy.<\/jats:p>","DOI":"10.1136\/bcr-2018-229135","type":"journal-article","created":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T11:54:32Z","timestamp":1556625272000},"page":"e229135","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Signet ring cell carcinoma of the rectum: atypical metastatic presentation"],"prefix":"10.1136","volume":"12","author":[{"given":"Mariana","family":"Morales-Cruz","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noel","family":"Salgado-Nesme","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia Maybi","family":"Trolle-Silva","sequence":"additional","affiliation":[{"name":"Department of Pathology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6584-7945","authenticated-orcid":false,"given":"Jorge Humberto","family":"Rodr\u00edguez-Quintero","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,4,30]]},"reference":[{"key":"2025082707323031000_12.4.e229135.1","doi-asserted-by":"crossref","first-page":"197","DOI":"10.3390\/ijms18010197","article-title":"Colorectal Carcinoma: A General Overview and Future Perspectives in Colorectal Cancer","volume":"18","author":"M\u00e1rmol","year":"2017","journal-title":"Int J Mol Sci"},{"key":"2025082707323031000_12.4.e229135.2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.65"},{"key":"2025082707323031000_12.4.e229135.3","first-page":"153","article-title":"Colorectal carcinoma: Pathologic aspects","volume":"3","author":"Fleming","year":"2012","journal-title":"J Gastrointest Oncol"},{"key":"2025082707323031000_12.4.e229135.4","doi-asserted-by":"publisher","DOI":"10.1007\/BF02305663"},{"key":"2025082707323031000_12.4.e229135.5","doi-asserted-by":"crossref","first-page":"691","DOI":"10.9738\/INTSURG-D-14-00067.1","article-title":"Outcomes of surgical treatment of primary signet ring cell carcinoma of the colon and rectum: 22 cases reviewed with literature","volume":"99","author":"Belli","year":"2014","journal-title":"Int Surg"},{"key":"2025082707323031000_12.4.e229135.6","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.canrad.2018.03.009","article-title":"Rare histologic types of rectal cancer: A monocentric cases series report","volume":"23","author":"Vallard","year":"2019","journal-title":"Cancer Radiother"},{"key":"2025082707323031000_12.4.e229135.7","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2018.0061"},{"key":"2025082707323031000_12.4.e229135.8","doi-asserted-by":"crossref","first-page":"262","DOI":"10.7150\/jca.7988","article-title":"Early detection of colorectal cancer recurrence in patients undergoing surgery with curative intent: current status and challenges","volume":"5","author":"Young","year":"2014","journal-title":"J Cancer"},{"key":"2025082707323031000_12.4.e229135.9","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/codi.14069","article-title":"A personal perspective of the development of MRI for Total Mesorectal Excision surgery","volume":"20 Suppl 1","author":"Heald","year":"2018","journal-title":"Colorectal Dis"},{"key":"2025082707323031000_12.4.e229135.10","doi-asserted-by":"crossref","first-page":"93","DOI":"10.4103\/0019-509X.25891","article-title":"Unusual metastasis in colorectal cancer","volume":"43","author":"Attili","year":"2006","journal-title":"Indian J Cancer"},{"key":"2025082707323031000_12.4.e229135.11","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s12253-017-0283-6","article-title":"Prognosis of Signet Ring Cell Carcinoma of the Colon and Rectum and their Distinction of Mucinous Adenocarcinoma with Signet Ring Cells. 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