Primary Linitis Plastica of the Rectum: Focus on Magnetic Resonance Imaging Patterns and Treatment Options

The American Journal of Case Reports
Jihane BoustaniJean-François Bosset

Abstract

Rectal linitis plastica (RLP) is a rare disease with poor outcome. It is often accompanied by a delayed histopathological diagnosis, primarily due to submucosal disease. A concentric ring pattern or "target sign" on T2-weighted magnetic resonance imaging (MRI) has been proposed as being characteristic for early suspicion. Even though RLP is more aggressive and has poorer survival than other rectal adenocarcinomas, no specific treatment is recommended. In this case report of 3 patients, we challenge the sensitivity of the characteristic radiological pattern, and we review the existing data for a treatment strategy. One patient presented classic clinical characteristics of RLP with young age and advanced stage at diagnosis, with chemo-refractory disease and rapid fatal evolution. Biopsies confirmed the RLP with the presence of signet-ring cells (SRC) in a strong desmoplastic stromal reaction. However, the characteristic concentric ring pattern was absent. Instead, he had a large vegetative lesion with important tumor infiltration in mesorectum and pelvic organs, with major lymph node involvement. The 2 other patients presented resectable locally advanced disease with characteristic concentric ring pattern. No clinical and radiolo...Continue Reading

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Citations

Apr 18, 2019·AJR. American Journal of Roentgenology·Amelia M WnorowskiMeghan G Lubner
Aug 16, 2017·Journal of Oncology Practice·Antoinette O'ConnorSeamus O'Reilly
Aug 25, 2021·Abdominal Radiology·Meena SutharAvanish Saklani

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Methods Mentioned

BETA
dissection
surgical resection

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