Linitis Plastica-Like Gastric Carcinoma in a 22-Year-Old South American Migrant: Histologic-Gross Discordance in an...

Gastric cancer in young patients is uncommon and frequently presents at an advanced stage with aggressive clinicopathological features. Diffuse gastric carcinoma, including linitis plastica, is characterised by widespread infiltration of the gastric wall and poor prognosis. We report a 22-year-old Venezuelan woman who presented with vomiting and weight loss and subsequently developed shortness of breath, fatigue, melaena, ascites, and generalised lymphadenopathy. Testing for Helicobacter pylori was performed, which was positive. Despite supportive management, she deteriorated rapidly and died shortly after readmission. Autopsy revealed diffuse gastric wall thickening with nodular ulcerative mucosa and peritoneal dissemination. Histology demonstrated a diffuse infiltrative carcinoma with prominent desmoplasia and lymph vascular invasion, consistent with a linitis plastica-like growth pattern. Metastatic carcinoma was present in the lymph nodes and both lungs. In the lungs, the tumour exhibited lepidic spread along the alveolar septae, resulting in consolidation and a pattern mimicking bronchioloalveolar carcinoma. This case highlights the aggressive behaviour of diffuse gastric carcinoma in young patients and underscores the importance of clinicopathological correlation.