La linite plastique rectale primitive, une tumeur exceptionnelle

Samlani-Sebbane, Z.; Eddafali, B.; Guennoun, N.; Krati, K.

doi:10.1016/j.gcb.2007.12.025

Cited by 4 publications

(8 citation statements)

References 6 publications

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“…Moreover, the disease was more advanced at surgery than at diagnosis in case 1, suggesting on-therapy progression. Other authors have reported the same isolated observations about probable chemo-radioresistance in RLP [ 15 – 17 ]. However, Bratland et al reported 6 cases of SRCC among 120 rectal cancer patients who received neoadjuvant CRT.…”

Section: Discussionsupporting

confidence: 68%

Primary Linitis Plastica of the Rectum: Focus on Magnetic Resonance Imaging Patterns and Treatment Options

et al. 2015

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Case seriesPatient: Male, 59 • Male, 85 • Male, 27Final Diagnosis: refractory metastatic rectal cancerSymptoms: —Medication: —Clinical Procedure: ChemotherapySpecialty: OncologyObjective:Challenging differential diagnosisBackground:Rectal linitis plastica (RLP) is a rare disease with poor outcome. It is often accompanied by a delayed histopathological diagnosis, primarily due to submucosal disease. A concentric ring pattern or “target sign” on T2-weighted magnetic resonance imaging (MRI) has been proposed as being characteristic for early suspicion. Even though RLP is more aggressive and has poorer survival than other rectal adenocarcinomas, no specific treatment is recommended. In this case report of 3 patients, we challenge the sensitivity of the characteristic radiological pattern, and we review the existing data for a treatment strategy.Case Report:One patient presented classic clinical characteristics of RLP with young age and advanced stage at diagnosis, with chemo-refractory disease and rapid fatal evolution. Biopsies confirmed the RLP with the presence of signet-ring cells (SRC) in a strong desmoplastic stromal reaction. However, the characteristic concentric ring pattern was absent. Instead, he had a large vegetative lesion with important tumor infiltration in mesorectum and pelvic organs, with major lymph node involvement. The 2 other patients presented resectable locally advanced disease with characteristic concentric ring pattern.No clinical and radiological responses were observed to neo-adjuvant chemoradiotherapy (CRT), including 1 patient with non-resectable disease at surgery and another with upstaged disease at pathological specimen after resection. However, data suggest 2 types of RLP: about half of patients are extremely sensitive to CRT with pathological complete response, and the other half are highly resistant with no response to CRT. Current data are insufficient to distinguish between these 2 populations.Conclusions:The absence of a concentric ring pattern should not eliminate the suspicion of RLP, especially in young patients with aggressive clinical presentation.There are probably 2 types of RLP in terms of chemoradiosensitivity, and neoadjuvant CRT could delay the curative-intent surgery in refractory patients. Future molecular analysis of the tumor and its environment are required to characterize the 2 different forms of RLP to develop more personalized treatment strategies.

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Section: Discussionsupporting

confidence: 68%

Primary Linitis Plastica of the Rectum: Focus on Magnetic Resonance Imaging Patterns and Treatment Options

et al. 2015

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“…Colic linitis affects equally males and females with a young age trend with invasion of the ganglions (86%) and the peritoneum but rarely hepatic metastasis [2].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Primary Linitis of the Colon Is a Rare Tumor

Ghannouchi¹,

Moussa²,

Khalifa³

et al. 2021

Preprint

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Primary colic linitis is a rare tumor .colonic biopsies are frequently negative. The search for a primitive is imperative, because only its negativity affirms the primary character of the tumor. The endoscopic exploration shows the integrity of the mucosa, with a narrowing lumen or impassable stenosis. The diagnosis is based on particular pathological criteria: submucosal spread and a scirrhous carcinoma with diffuse thickening and hardening of the bowel wall consisted of independent signet ring cells. Immunohistochemistry could help in the differential diagnosis between primary colonic ADK (CK7-; CK20+) and colonic metastasis from gastric linitis (CK 7+, CK 20). In our case, tumor cells were positive for CDX2 (intensive and diffuse marking). Primary colic linitis is a rare but extremely aggressive, diagnosed at a late stage. Lymphatic metastases often found at the time of the diagnosis makes the prognosis very pejorative.

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“…The search for a primary extra-rectal tumor, especially gastric, must be systematic, because only its negativity affirms the primitive nature of the lesion. Secondary rectal linitis is more frequent, most often corresponding to the metastasis of a gastric cancer, and more rarely, to cancers of gall bladder, breast, or prostate [8,9]. Linitis has a predominantly locoregional extension to the lymphatic (lymphadenopathy: 86%), pelvic (ovary, trunk, and uterus: 58%) and peritoneal (47%) areas.…”

Section: Discussionmentioning

confidence: 99%