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The sigmoidoscope tube could not be negotiated through this narrowing. Laboratory investigations station were normal. The station plain abdominal radiograph showed multiple air fluid levels suggestive of mechanical large bowel obstruction. Contrast enhanced computerized tomographic (CT) scan [Figure - 1] revealed " whorl - like" circumferential rectal wall thickening with marked luminal narrowing. Large bowel loops proximal to the rectum were dilated. The adjacent organs were normal. There was no evidence of lymphadenopathy or hepatic station / peritoneal metastasis. Histopathological examination of the rectal biopsy specimen showed mucin secreting signet ring cells [Figure - 2], diffusely infiltrating into the submucosa and muscularis propria. There was marked desmoplastic reaction in the submucosa. The patient underwent radical surgical resection of the tumour followed by a permanent colostomy from which he made an uneventful recovery. The patient was lost to further follow-up. :: Discussion The mucogenic, diffusely infiltrating and poorly differentiated variety of adenocarcinoma constitutes the scirrhous adenocarcinoma.
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