Rectal linitis case series: An infrequent entity

Linitis Plastica (LP) is a rare condition characterized by diffuse infiltration of the submucosal and muscularis propria layers of a hollow organ by malignant cells.

Three patients underwent colonoscopy, which revealed rectal stenosis with preserved mucosa. CT and MRI demonstrated circumferential thickening of the rectal wall. Histopathological and immunohistochemical analyses confirmed submucosal infiltration by malignant cells. All three patients received chemotherapy but died due to disease progression.

Symptoms of rectal LP are nonspecific. Rectal examination typically reveals a concentric, rigid stricture. Colonoscopy shows circumferential luminal narrowing with intact mucosa. Imaging studies detect circumferential rectal wall thickening primarily affecting the submucosa. A definitive diagnosis requires histological analysis, but endoscopic biopsies are often non-diagnostic. Given the typically late-stage diagnosis and lack of effective treatments, chemotherapy is the mainstay, with surgery reserved for complications. Prognosis remains poor.

The diagnosis and management of rectal LP present significant challenges due to its rarity, nonspecific endoscopic findings, and frequently inconclusive biopsies.