Multiple intestinal metastases from signet ring cell cancer of the stomach.

A man in his early 40s presented with abdominal pain, diarrhoea, abdominal distension and pedal oedema. Imaging revealed multiple levels of stricture of both the small and large bowel with segmental areas of mucosal hyperenhancement, gross ascites, omental thickening and mild thickening of the gastric mucosa. We initially suspected Crohn's disease. However, the endoscopy showed a gastric ulcer and multiple ulcero-stenotic lesions in the colon. Biopsy and immunohistochemistry revealed signet ring cell cancer of the stomach with metastases to the small intestine and colon. He received the best supportive care and died after 4 weeks.