Linitis Plastica of the Colon and Rectum

Abstract

The patient complained of rectal bleeding, diarrhea, and lower abdominal discomfort for 2 months. There had been a weight loss of 35 lbs in 12 months. A nonmobile mass was present in the left lower abdomen. On rectal examination and sigmoidoscopy, abnormal mucosa was present that was not typical of adenocarcinoma. Crohn’s Disease was considered prior to referral. A barium enema demonstrated a long stricture with “scalloped” margins involving rectum and sigmoid. Biopsy of “inflamed and edematous mucosa” at 10cm revealed anaplastic carcinoma. Biopsy of an enlarged lymph node in the neck (Figure 30.1) showed anaplastic carcinoma with signet ring cells present. Other investigations revealed the patient was suffering from thyrotoxicosis, and therapy with carbimazole was commenced. Despite the ominous prognosis, operation was performed since the patient had constant rectal symptoms and requested that at least an exploratory laparotomy be undertaken.