Images in Surgery| Volume 154, ISSUE 3, P641-642, September 2013

Rectal linitis

      This section features outstanding photographs of clinical materials selected for their educational value or message, or possibly their rarity. The images are accompanied by brief case reports (limit 2 typed pages, 4 references). Our readers are invited to sumit items for consideration.
      A 77-year-old man with a history of total gastrectomy for gastric linitis (7 years before presentation) was referred to our center for abdominal pain and rectorragy. A 20-kg weight loss was noted. An upper gastrointestinal tract endoscopy was normal, and a colonoscopy revealed a circular tumoral mass occluding the inferior rectal lumen. The histopathologic evaluation of a biopsy specimen taken from the mass revealed poorly differentiated adenocarcinoma that was characterized by signet ring cells. A computed tomographic scan of the pelvis and abdominal area and a magnetic resonance imaging scan of the pelvis confirmed the circular tumor infiltrate with a longitudinal extension of 8 cm (Figure). Preliminary investigations excluded local or distant adenopathy or distant metastasis.
      Figure thumbnail gr1
      FigureContrast-enhanced computed tomographic scan revealing “whorl-like” circumferential rectal wall thickening with partial obliteration of the lumen (A) and downward extension of tumor invasion to the lower rectum and the level of the anal verge with infiltration into the perirectal fat plane (B).
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Correia J.P.
        • Baptista A.S.
        • António J.F.
        Slowly evolving widespread diffuse alimentary tract carcinoma (linitis plastica).
        Gut. 1968; 9: 485-488
        • Dixon C.F.
        • Stevens G.A.
        Carcinoma of linitis platica type involving the intestine.
        Ann Surg. 1936; 103: 263-272
        • Papp J.P.
        • Levine E.J.
        • Thomas F.B.
        Primary linitis plastica carcinoma of the colon and rectum.
        Am J Gastroenterol. 1995; 90: 141-145
        • Rudralingam V.
        • Dobson M.J.
        • Pitt M.
        • Stewart D.J.
        • Hearn A.
        • Susnerwala S.
        MR imaging of linitis plastica of the rectum.
        AJR Am J Roentgenol. 2003; 181: 428-430
        • El Absi M.
        • Elouannani M.
        • Elmdarhri J.
        • Echarrab M.
        • El Amraoui M.
        • Alami F.
        Primary linitis plastica of the rectum.
        Rev Med Liege. 2002; 57: 10-12