1/51. The evolution of linitis plastica as a consequence of advanced gastric carcinoma in pregnancy. A 40-year-old multigravid woman was examined on multiple occasions during pregnancy because of persistent gastrointestinal symptoms. A metastatic, unresectable gastric carcinoma that had evolved to linitis plastica was diagnosed at 26 weeks' gestation. The patient was delivered of a viable infant at 27 weeks' gestation, and she died of disease 1.5 months after the diagnosis was made. ( info) |
2/51. Primary linitis plastica of the rectosigmoid in a thirteen year old boy. Childhood malignant neoplasms of the gut are extremely rare. The reported incidence of colorectal cancers in patients under 20 years of age is 1 in 10 million. The low index of suspicion for this tumour in children results in advanced disease at diagnosis and subsequently a poor prognosis. A rare case of a primary linitis plastica of the rectum occurring in a 13 year old boy is reported with review of pertinent literature. ( info) |
3/51. A new mutation of E-cadherin gene in familial gastric linitis plastica cancer with extra-digestive dissemination. Over a 12-month period, we diagnosed poorly differentiated infiltrative independent-cell gastric adenocarcinoma in two brothers and one sister aged 41 to 47 years. Their father had died from antral cancer at the age of 34 years. These cancers had two characteristic clinical features: rapid course and distant malignant dissemination. In all three patients, polymerase chain reaction-sequencing of the E-cadherin (CDH1) gene of white blood cells identified a heterozygous nonsense mutation of exon 3, producing a stop codon at position 95 (Q95X), resulting in a truncated protein. The alteration of this protein, which plays a crucial role in epithelial cell adhesion, probably explains the clinical expression in this type of familial diffuse gastric cancer. ( info) |
4/51. Gastric linitis adenocarcinoma and carcinomatous meningitis: an infrequent but aggressive association--report of four cases. Carcinomatous meningitis (CM) is a very rare complication of gastrointestinal malignancies and especially gastric adenocarcinoma. linitis plastica (LP), which is a specific form of gastric neoplasia, locally penetrates through the gastric wall to reach the peritoneum. lymph node involvement is frequent and metastatic sites are almost exclusively observed in the abdominal cavity. The meningeal localization is extremely rare with only a few cases described in the literature. We report here, over a five-year period, four cases of CM on a total of eighty linitis cases diagnosed and treated in our institution, which represent 5% of a non selected linitis population. The clinical manifestations were clearly poor, and characterized by aspecific neurological signs. The diagnosis was made by the discovery of signet cells in the cerebrospinal fluid. Invasive treatment, consisting of intrathecal infusion of chemotherapy, was undertaken with mixed clinical response and no cytological normalization of the cerebrospinal fluid (CSF). In conclusion, our observation which is based on a large series of successive gastric linitis, demonstrates a 5% frequency of developing CM with a predominance among metastatic patients. Furthermore, the diagnosis of CM must be done as soon as possible because of the clear effectiveness of a therapeutic approach on the improvement of symptoms and quality of life. ( info) |
5/51. CT demonstration of pelvic wall spread in primary colonic linitis plastica. Primary linitis plastica of the colon is a rare entity, and its radiographic and CT findings have been described in previously published literature. We present the CT demonstration of the pelvic wall spread in this unusual disease, and briefly review its radiologic and pathologic features. ( info) |
6/51. An African patient with AIDS and linitis plastica. This is a case report about an African patient with AIDS who was diagnosed with a linitis plastica of the stomach. The evolution of this linitis plastica does not differ in any aspect from that in hiv-negative patients. The question remains unanswered whether there is a link between the hiv infection and the development of linitis plastica in this patient. ( info) |
| linitis plastica of the colon is an uncommon presentation of primary colorectal cancer. This entity of colorectal cancer is characterized by a diffuse infiltrating tumor with desmoplastic reaction and poor prognosis. Although widespread infiltration is the main feature of linitis plastica, the tumor extending to more than 2 segments of the colon is uncommon. We report a case of primary linitis plastica involving the entire colon, ileum and appendix. The clinical characteristics are discussed with a review of literatures. ( info) |
8/51. Primary linitis plastica carcinoma of the colon accompanied by peritoneal abscess. We describe the case of a 75-year-old woman with linitis plastica carcinoma of the colon, accompanied by a peritoneal abscess, in which the use of transabdominal sonography enabled prompt detection and diagnosis. Sonographic examinations revealed diffuse wall thickening with blurred layer stratification in the ascending colon. The irregular outer margin of the affected area was surrounded by thickened pericolic fat. A peritoneal abscess covered by the omentum was also found. CT confirmed these findings. We extensively resected the right half of the colon. Histopathologic examination of the excised segment of the colon revealed a poorly differentiated adenocarcinoma with fibrotic infiltration. The patient was discharged 6 weeks postoperatively, and chemotherapy was begun, but she was lost to our follow-up. Although linitis plastica carcinoma of the colon is rare, it must be considered when patients have extensive colonic wall thickening with blurred layer stratification and an irregular outer margin surrounded by thickened pericolic fat. Transabdominal sonography should be considered the imaging modality of choice for the detection and diagnosis of this disease entity. ( info) |
| Multidisciplinary treatment was administered to a 32 year-old man with primary linitis plastica of the rectum, which was considered inoperable due to an extensive local spread at the first operation. Thirty KE of OK-432 was injected into the tumor per week (total 90-KE) and 5 KE of OK-432 was inoculated into the intracutaneous space per week (total 125 KE). Also methotrexete (MTX 50 mg) and 5-FU (500 mg) combined were given each week by intra-arterial infusion (total 20 courses). After this immuno-chemotherapy the CEA decreased from the pretreatment value of 12.7 ng/ml to 3.6 ng/ml and the tumor size was reduced. A total pelvic exenteration could then be performed almost curatively. As a result, this patient was able to return to the society with a better quality of life and has survived for 20 months since presentation. ( info) |
| Early detection and treatment of breast cancer, leading to longer survival, has revealed the natural history of this disease process. linitis plastica of the stomach is a potential long-term sequela of metastatic breast cancer. Here we present a case of metastatic breast cancer presenting as linitis plastica, as well as the treatment algorithm for this rare clinical entity. The world literature describes a clear pattern of linitis plastica for metastatic infiltrating lobular breast cancer and a discrete nodular pattern for infiltrating ductal cancer, in regard to metastasis to the stomach. To our knowledge, this is the first case of infiltrating ductal cancer presenting as linitis plastica of the stomach. ( info) |