General Surgeon, Surgery and Anatomopathology Service of Hospital General Playa del Carmen, Constituyentes Avenue with Avenue 135 EjidoSuburb, Playa del Carmen, Quintana Roo. Mexico. CP. 77712.
Anatomopathology, Surgery and Anatomopathology Service of Hospital General Playa del Carmen, Constituyentes Avenue with Avenue 135 EjidoSuburb, Playa del Carmen, Quintana Roo. Mexico. CP. 77712
Backgrounds: The term linitis plastic was used by Brinton to designate a special disease of the stomach, benign in nature, characterized, pathologically, by a diffuse or circumscribed increase in the connective tissue involving chiefly the submucosa, and to a lesser degree the other layers, giving rise to a marked thickening of the stomach walls with a corresponding diminution in its lumen; clinically, by its insidious onset, its slow progressive gastric symptoms, its cachexia, and fatal termination.
Clinical case: Male of 49 years-old presenting dyspepsia, weight loss (15 kg) of 6 months of evolution treated with alternative medicine (herbal) without improvement. Request panendoscopy by observing: marked thickening of the gastric mucosal folds, which were difficult to distend and gastric wall rigidity. Some gastric folds were enlarged and some parts of the mucosa had a mosaic pattern and a “snake skin” aspect. Biopsies are taken and the histopathological study revealed an undifferentiated adenocarcinoma with signet ring cell. The patient is sent to a third level of cancer care for their comprehensive treatment.
Discussion: The cumulative lifetime risk of clinically detected gastric cancer is 63%-83% for women and 40%-67% for men. The average age at diagnosis is 40 years. The treatment for linitis plastic is a controversial issue. Some authors have proposed using more radical multimodality treatments such as systemic and/or intraperitoneal chemotherapy in addition to radical surgery, whereas others suggest that these patients should be treated with primary chemotherapy even in the absence of unfavorable parameters, as the overall survival rate has been reported to be low in patients undergoing curative surgery.