Rectal linitis case series: An infrequent entity

Area of Science:

• Gastroenterology
• Oncology
• Pathology

Background:

• Linitis Plastica (LP) is a rare condition involving diffuse infiltration of malignant cells into the submucosal and muscularis propria layers of hollow organs.
• Rectal LP specifically presents diagnostic challenges due to its rarity and nonspecific clinical manifestations.

Purpose of the Study:

• To highlight the diagnostic challenges and poor prognosis associated with rectal Linitis Plastica.
• To review the clinical presentation, diagnostic modalities, and management of rectal LP.

Main Methods:

• Case series involving three patients with rectal Linitis Plastica.
• Diagnostic procedures included colonoscopy, CT, MRI, and histopathological/immunohistochemical analyses.
• Treatment involved chemotherapy, with surgery reserved for complications.

Main Results:

• Colonoscopy revealed rectal stenosis with preserved mucosa; imaging showed circumferential rectal wall thickening.
• Histopathology confirmed submucosal infiltration by malignant cells.
• All patients received chemotherapy but experienced disease progression, indicating a poor prognosis.

Conclusions:

• Rectal LP exhibits nonspecific symptoms and characteristic endoscopic/imaging findings of submucosal thickening.
• Definitive diagnosis requires histology, but biopsies can be non-diagnostic.
• Late diagnosis and limited treatment options contribute to a poor prognosis, with chemotherapy as the primary therapy.