RT Journal Article SR Electronic T1 Signet ring cell carcinoma of the rectum: atypical metastatic presentation JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e229135 DO 10.1136/bcr-2018-229135 VO 12 IS 4 A1 Mariana Morales-Cruz A1 Noel Salgado-Nesme A1 Alicia Maybi Trolle-Silva A1 Jorge Humberto Rodríguez-Quintero YR 2019 UL http://casereports.bmj.com/content/12/4/e229135.abstract AB Colorectal cancer is the third most common cancer in the world and the fourth most common cause of death related to cancer. Signet ring cell carcinoma represents an uncommon histological type for rectal cancer with less than 1% of all rectal neoplasms. It usually behaves aggressively and has an inferior prognosis. We present the case of a young man diagnosed with signet ring cell rectal carcinoma. He underwent neoadjuvant therapy with partial response, had surgery with curative intent and showed local recurrence after only 3 months. Disease progression happened only weeks after recurrence with metastasis to vertebrae, extraocular muscles, bone marrow and skin. He is currently receiving palliative chemotherapy.