Linitis plastica carcinoma of the colon mimicking Crohn's colitis.

Primary linitis plastica carcinoma of the colon is an uncommon morphological type of colorectal carcinoma. Linitis plastica of the stomach may spread to the colon producing a similar lesion to primary colonic linitis plastica. This case report describes a case of linitis plastica of the colon that had many of the clinical, endoscopic, radiological and operative features of Crohn's colitis. The precise origin of the linitis plastica carcinoma was not clear: it may have been clonic or gastric, although the former is favoured. This case illustrates a number of facets of this unusual colonic carcinoma.     

Metastatic breast carcinoma simulating linitis plastica of the colon: Report of a case

A 48-year-old woman developed a mobile abdominal mass in the course of treatment for recurrent breast cancer. Imaging studies indicated linitis plastica of the colon. She underwent surgery because of the stenosis of the transverse colon. An examination of the resected specimen revealed a segmental stricture, thickening of the entire wall, and a granular mucosa resembling cobblestones. Microscopic findings of the colon lesion were very similar to those of her primary, invasive lobular carcinoma of the breast. Atypical cells showed immunoreactivity for cytokeratin-7, but not for cytokeratin-20. These findings suggested that the lesion of the colon was a colonic metastasis of breast cancer. Metastatic gastrointestinal diseases originating from breast carcinoma are unusual, and colonic metastases are especially rare. Although colon cancer may occur in patients with a history of breast cancer, metastatic colon cancer should be suspected if linitis plastica is detected.     

Linitis plastica in a child

Anaplastic infiltrative adenocarcinoma of the linitis plastica morphologic type is rare in children. The case of a 15-year-old child with this unusual form of gastric carcinoma is presented. One year postoperatively following radiation and chemotherapy, the child is free of disease.     

Linitis plastica of the cecum

Linitis plastica of the cecum is rare. The authors describe a case of this condition in a 16-year-old man. The commonest presenting symptom is a change in bowel habit. Histologically there are three recurring features--diffuse infiltration of the bowel wall by small darkly staining tumour cells, the presence of multiple "signet-ring" cells indicating mucin production and, third, an attempt at gland formation. The prognosis is poor; no patient has survived longer than 27 months.     

Linitis plastica extending through the entire digestive tract. A case report

A 43-year-old man who presented a perplexing diagnostic challenge, had diffuse linitis plastica involving the entire gastrointestinal tract (autopsy). Although the usual primary site is the stomach in case of linitis plastica, invasion of the large and small bowel is rarely seen, but must be searched with proctoscopic exam and barium enema. We review the literature and discuss the pathogeny of this disorder.     

Linitis plastica of the proximal part of the duodeno-jejunal angle. Apropos of a case]

The authors report the first case to date of primary linitis plastica localised to the proximal part of the small bowel. A 44-year-old man with a one-month history of vague abdominal symptoms was treated for a proximal jejunum perforation due to a linitis plastica and died 2 months later.     

Linitis plastica of the stomach. Factors influencing prognosis]

The authors make a retrospective study of a series of 57 patients aged 63 years in average, followed up from 1979 to 1989 for linitis plastica of the stomach. Surgical exeresis was performed in 49 patients (34 total gastrectomies and 15 partial gastrectomies, including five 2/3 gastrectomies, two 3/4 gastrectomies, four 4/5 gastrectomies and four upper polar esogastrectomies). The overall actuarial survival rate (n = 57) was 62.5% at 1 year, 40% at 2 years and 12.5% at 5 years. The prognosis did not vary with the delay of diagnosis, the invasion of the area of resection, the associated tissue differentiation and the invasion of lymph nodes. It did very according to the height of the tumor: 22% survival at 5 years for tumors under 6 cm, against 0% for tumors exceeding 6 cm (p < 0.001).     

Linitis plastica of the bypassed stomach 7 years after Roux-en-Y gastric bypass: a case report

Laparoscopic Roux-en-Y gastric bypass (RYGB) is currently the preferred surgical procedure to treat morbid obesity. It has proven its effects on excess weight loss and its positive effect on comorbidities. One of the main issues, however, is the post-operative evaluation of the bypassed gastric remnant. In literature, cancer of the excluded stomach after RYGB is rare. We describe the case of a 52-year-old woman with gastric linitis plastica in the bypassed stomach after Roux-en-Y gastric bypass, diagnosed by means of laparoscopy and Single-Balloon enteroscopy, and it is clinical importance. Linitis plastica of the excluded stomach after RYGB is a very rare entity. This case report shows the importance of long-term post-operative follow-up, and the importance of single-balloon enteroscopy for visualization of the bypassed stomach remnant, when other investigations remain without results. This case report is only the second report of a linitis plastica in the bypassed stomach after Roux-en-Y gastric bypass.     

Primary linitis plastica of the descending colon: a case report

A rare case of primary linitis plastica carcinoma of the colon seen in a 44 year old Japanese man is described herein. The patient had a complete obstruction of the descending colon and was treated with a loop colostomy followed shortly afterward by a left hemicolectomy. At the time of the second operation, the entire thickness of the colonic wall was found to be infiltrated by cancer cells, however, the other intraabdominal organs were free of cancerous involvement. The histopathological diagnosis made at this time was primary linitis plastica carcinoma of the descending colon. Nine months later, the patient developed an intestinal obstruction and relaparotomy revealed diffuse peritoneal dissemination. Two years after the first operation, upper GI films and a gastrofiberscopic examination revealed gastric involvement. The patient died 28 months after his initial operation, and autopsy revealed widespread metastases in the peritoneal surface, paraaortic lymph nodes, small intestine, remaining colon and stomach.     

Obstructive ileitis secondary to colon cancer: report of a case

We report a case of obstructive ileitis (OI) secondary to colon cancer. A 62-year-old man was hospitalized for abdominal pain and a feeling of fullness. Examinations revealed a mechanical ileus caused by an obstructing carcinomatous lesion of the cecum. He underwent laparotomy on the tenth hospital day, and a right hemicolectomy was carried out with resection of the distended and edematous ileum. The histopathologic diagnosis was adenocarcinoma in the cecum involving the ileocecal valve and nonspecific inflammatory change of the ileum, with mucosal necrosis and neutrophilic infiltration involving the subserosal layer. His postoperative course was uneventful. OI does not always show similar histological features to obstructive colitis; however, they are both important types of obstructing lesions, and their possibility must be kept in mind during colorectal cancer surgery. Received: March 4, 2002 / Accepted: July 2, 2002 Reprint requests to: T. Matsuda     

Primary linitis plastica of the descending colon: A case report

A rare case of primary linitis plastica carcinoma of the colon seen in a 44 year old Japanese man is described herein. The patient had a complete obstruction of the descending colon and was treated with a loop colostomy followed shortly afterward by a left hemicolectomy. At the time of the second operation, the entire thickness of the colonic wall was found to be infiltrated by cancer cells, however, the other intraabdominal organs were free of cancerous involvement. The histopathological diagnosis made at this time was primary linitis plastica carcinoma of the descending colon. Nine months later, the patient developed an intestinal obstruction and relaparotomy revealed diffuse peritoneal dissemination. Two years after the first operation, upper GI films and a gastrofiberscopic examination revealed gastric involvement. The patient died 28 months after his initial operation, and autopsy revealed widespread metastases in the peritoneal surface, paraaortic lymph nodes, small intestine, remaining colon and stomach.     

Blind pouch syndrome secondary to gastrojejunostomy. Report of a case

A case of blind pouch syndrome following a Roux-en-Y reconstruction after gastrectomy is presented. The patient had a history of pain, anaemia and weight loss and the diagnosis was made on the basis of upper gastrointestinal barium contrast radiography. The surgical procedure was an entero-entero anastomosis between the blind loop and the efferent loop. The postoperative course was uneventful. No symptomatic recurrence was found at one-year follow-up. We advocate this procedure as a valid alternative to resection in cases where the blind loop is not damaged by chronic dilatation. The aim of this operation is to maintain the preferential gastric emptying route via the blind loop in order to prevent recurrence on the stump, and reduce loop isolation in order to minimise ischemic or stenotic damage to the anastomosis.     

Cronkhite-canada syndrome associated with colon cancer: Report of a case

A 68-year-old man with the clinical features of Cronkhite-Canada syndrome developed cancer of the ascending colon. Although Cronkhite-Canada syndrome has always been considered a benign condition, it may be a premalignant disorder, as suggested by the clinical course of the patient whose case is described herein.     

Endoluminal metastasis of colon cancer to the urinary bladder via the ureter: Report of a case

A 67-year-old woman was admitted for intermittent gross hematuria. Her medical history included a right colectomy for cancer of the ascending colon and removal of metastatic nodes adjacent to the right internal iliac vessels, respectively at 63 and 65 years of age. Cystoscopy detected a semi-pedunculated, nonpapillary (3.5–4 cm diameter) tumor situated above the right ureteral orifice. The histological evaluation of the resected specimen revealed metastatic colonic adenocarcinoma. The history and pathological findings were consistent with a mechanism of endoluminal implantation of adenocarcinoma of the large bowel to the bladder via the right ureter.