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Linitis Plastica

Leather-Bottle Stomach


Presentation

  • Gastric tuberculosis is rare and usually presents as an ulcerated lesion or gastric outlet obstruction. Rarer presentations include massive gastrointestinal bleed and gastric perforation.[ncbi.nlm.nih.gov]
  • A patient with primary linitis plastica of the colon has been presented. The unusually aggressive nature of this tumor is demonstrated in a young man who presented with obstructive uropathy.[ncbi.nlm.nih.gov]
  • Here we present a case of metastatic breast cancer presenting as linitis plastica, as well as the treatment algorithm for this rare clinical entity.[ncbi.nlm.nih.gov]
  • Methods: We present the case of a 57-year-old woman with a history of signet cell gastric adenocarcinoma (linitis plastica) and a Krukenberg tumor who presented with nausea, blurry vision, and a chronic headache of two months’ duration.[n.neurology.org]
  • We report two cases, including the oldest known patient presenting uniquely with a sigmoid volvulus and another patient presenting with fecal incontinence and perianal pain.[ncbi.nlm.nih.gov]
Weight Loss
  • A 62-yr-old woman was evaluated for a 2-wk history of regurgitation and weight loss. Radiologic studies demonstrated a stenotic region in the distal third of the esophagus. Multiple endoscopic biopsies were nondiagnostic.[ncbi.nlm.nih.gov]
  • Two patients, 60 and 62 years old, were admitted with progressive dysphagia and weight loss of 8 to 12 weeks duration. Radiographic studies revealed an area of stenosis in the lower third of the esophagus in both cases.[ncbi.nlm.nih.gov]
  • The patient was a young woman who presented with non-specific abdominal pain and significant weight loss. The gastric mucosa appeared oedematous and hyperaemic and there was spontaneous oozing of blood on upper gastrointestinal endoscopy.[ncbi.nlm.nih.gov]
  • A 52-year-old Caucasian woman presented with progressive nausea and vomiting, weight loss, and burning epigastric and chest pain.[ncbi.nlm.nih.gov]
  • A 60-year-old woman had progressive lower abdominal pain, nonbloody diarrhea, and weight loss, followed by severe epigastric pain and dysphagia.[ncbi.nlm.nih.gov]
Chills
  • After chilling on ice, 4 µl of 5 synthesis buffer (250 mM Tris–HCl, pH 8.3, 375 mM KCl and 15 mM MgCl 2 ) plus 2 µl of 100 mM dithiothreitol, 4 µl of each dNTP at 2.5 mM and 1 µl of SuperScript II RNase H reverse transcriptase (200 units/µl; I-gene CA[academic.oup.com]
Constitutional Symptom
  • There was an episode of urinary tract infection (UTI) but no constitutional symptoms or hematuria. On evaluation, elsewhere, she had been detected to have bilateral hydroureteronephrosis and had undergone bilateral double J stenting.[indianjrheumatol.com]
Abdominal Pain
  • The patient was a young woman who presented with non-specific abdominal pain and significant weight loss. The gastric mucosa appeared oedematous and hyperaemic and there was spontaneous oozing of blood on upper gastrointestinal endoscopy.[ncbi.nlm.nih.gov]
  • We report a case of primary linitis plastica of the sigmoid colon in a 32-year-old Chinese woman who presented with a 7-month history of constipation and associated abdominal pain and tenesmus.[ncbi.nlm.nih.gov]
  • A 60-year-old woman had progressive lower abdominal pain, nonbloody diarrhea, and weight loss, followed by severe epigastric pain and dysphagia.[ncbi.nlm.nih.gov]
  • A 46-year-old woman presented witb epigaseric abdominal pain and loss of abbetite. Computed tomography of her abdomen revealed diffuse thickening of a portion of the gastric wall.[ncbi.nlm.nih.gov]
  • A 59-year-old female with depressive tendencies was admitted suffering from hematemesis and abdominal pain, two hours after ingestion of an unknown amount of toilet bowl cleaner (hydrochloric acid, pH 1.0).[ncbi.nlm.nih.gov]
Vomiting
  • Sijil kottikkal sivaraman Email: drsijil@gmail.com DOI : Case report A 43-year-old lady without associated comorbidity presented with upper abdominal dull aching pain, persistent nonbilious vomiting,loss of appetite and loss of weight.Clinical examination[tropicalgastro.com]
  • A 52-year-old Caucasian woman presented with progressive nausea and vomiting, weight loss, and burning epigastric and chest pain.[ncbi.nlm.nih.gov]
  • Symptoms often associated with LP of the stomach include pain and lump in the epigastrium, weight loss, anorexia, dysphagia, nausea and vomiting.[ncbi.nlm.nih.gov]
  • Dyspepsia was the commonest feature of presentation (55%), followed by dysphagia (33%), vomiting (33%) and weight loss (33%).[ncbi.nlm.nih.gov]
  • Symptoms are similar to those of stomach cancer, including difficulty swallowing, weight loss, indigestion, and vomiting. [3] Notable cases [ edit ] Napoleon Bonaparte and many members of his family are thought to have died from this type of cancer, although[en.wikipedia.org]
Dysphagia
  • Two patients, 60 and 62 years old, were admitted with progressive dysphagia and weight loss of 8 to 12 weeks duration. Radiographic studies revealed an area of stenosis in the lower third of the esophagus in both cases.[ncbi.nlm.nih.gov]
  • A 60-year-old woman had progressive lower abdominal pain, nonbloody diarrhea, and weight loss, followed by severe epigastric pain and dysphagia.[ncbi.nlm.nih.gov]
  • Symptoms often associated with LP of the stomach include pain and lump in the epigastrium, weight loss, anorexia, dysphagia, nausea and vomiting.[ncbi.nlm.nih.gov]
  • Dyspepsia was the commonest feature of presentation (55%), followed by dysphagia (33%), vomiting (33%) and weight loss (33%).[ncbi.nlm.nih.gov]
  • Patients with gastric cancer will present with abdominal pain and weight loss more than 50% of the time. 2 Additional symptoms include nausea, dysphagia, gastrointestinal bleeding (hematemesis, melena), and early satiety.[cancertherapyadvisor.com]
Nausea
  • A 52-year-old Caucasian woman presented with progressive nausea and vomiting, weight loss, and burning epigastric and chest pain.[ncbi.nlm.nih.gov]
  • A total gastrectomy was performed about two months after ingestion to relieve the persistent feeling of nausea. Specimens revealed a rigid and thickening lining and a denuded mucosal surface of the stomach.[ncbi.nlm.nih.gov]
  • Symptoms often associated with LP of the stomach include pain and lump in the epigastrium, weight loss, anorexia, dysphagia, nausea and vomiting.[ncbi.nlm.nih.gov]
  • Methods: We present the case of a 57-year-old woman with a history of signet cell gastric adenocarcinoma (linitis plastica) and a Krukenberg tumor who presented with nausea, blurry vision, and a chronic headache of two months’ duration.[n.neurology.org]
  • World J Surg Oncol 2017 ; 15 : 123. 2 Just scratching the surface: intractable nausea and vomiting. Am J Med 2015 ; 128 : e3 – 5. 3, et al. Scirrhous gastric carcinoma: endoscopy versus upper gastrointestinal radiography.[academic.oup.com]
Early Satiety
  • Patients with LP will have more intense symptoms presented with gastric cancer in addition to early satiety and how much stomach involvement there is since it may lead to limited distensibility. Diagnosis & Staging View Full Article Related Videos[debbiesdream.org]
  • Early satiety may be more prominent in patients in LP based on the diffuse involvement of the stomach, which causes limited distensibility.[cancertherapyadvisor.com]
  • Left: 76 year-old woman with several months of progressive loss of appetite, early satiety and weight loss. The walls of the stomach appeared thickened, and the stomach distended poorly.[endoatlas.com]
  • The player requires Flash Player plugin Case description A 35 year-old female, who began her disease with jaundice, weight loss, early satiety, nausea and vomiting. The endoscopy was performed and all the gastric mucosa and walls were infiltrated.[medtube.net]
Withdrawn
  • Withdrawn: neoadjuvant chemotherapy versus none for resectable gastric cancer. Cochrane Database Syst Rev. 2007;4:CD005047. Google Scholar 22. Okabe H, Ueda S, Obama K, Hosogi H, Sakai Y.[link.springer.com]
Irritability
  • In general, this tumor present with hematuria and irritative symptoms, and may yield equivocal radiologic and cystoscopic findings.[ncbi.nlm.nih.gov]
  • The effect of new diagnostic criteria for irritable bowel syndrome on community prevalence estimates. Neurogastroenterol Motil,15: 687-694, 2003. 3-Drossman DA; Corrazziari E; Delvaux M. et al.[scla.org.sy]
  • Her medical history was significant for hypertension and irritable bowel syndrome. On physical examination, her abdomen was distended with generalized tenderness, but no guarding was noted.[journals.lww.com]
  • […] bowel syndrome (irritable colon syndrome)過敏性腸症候群 irritable colon刺激性結腸 j jaundice (icterus)黄疸 jejunum空腸 k ketone bodyケトン体 ketone groupケトン基 l lamina muscularis mucosae粘膜筋板 laparoscope (peritoneoscope)腹腔鏡 laparoscopic cholecystectomy (lapcholy)腹腔鏡下胆嚢摘出術[tokyo-med.ac.jp]

Workup

  • Post -operative clinico-radiological workup was done to exclude secondary.[ncbi.nlm.nih.gov]
  • The patient was diagnosed as Crohn’s disease and further workup revealed multiple strictures in the small bowel though large bowel was normal and subsequently managed with azathioprine and supportive medications.[tropicalgastro.com]
  • The mucosa can, however, also appear normal, which requires high clinical suspicion in further workup. The antrum and pylorus are most commonly involved in LP, while the fundus is the least involved.[cancertherapyadvisor.com]
  • The patient was admitted to the hospital and underwent an additional workup, including upper endoscopy. The endoscopic examination revealed a large friable mass in the antrum.[onlinelibrary.wiley.com]
Small Liver
  • In 40 of these cases a circumscribed peritoneal carcinomatosis and in 12 patients small liver metastases could be resected.[eurjmedres.biomedcentral.com]

Treatment

  • Treatment for linitis plastica in the stomach The main treatments for linitis plastic are surgery or chemotherapy. You might also have radiotherapy to help relieve your symptoms. Unfortunately, most people won't be able to have surgery.[cancerresearchuk.org]
  • Sometimes an endoscopic ultrasound is useful to establish the diagnosis and in guiding treatment. The treatment for linitis plastica is a controversial issue.[ncbi.nlm.nih.gov]
  • Moreover, EUS can be useful in evaluating the response of this disease to treatment.[ncbi.nlm.nih.gov]
  • In our series of 8 patients, only one patient was offered surgery; the rest were offered palliative or supportive treatment.[ncbi.nlm.nih.gov]
  • Here we present a case of metastatic breast cancer presenting as linitis plastica, as well as the treatment algorithm for this rare clinical entity.[ncbi.nlm.nih.gov]

Prognosis

  • Of significance is the fact that it carries a prognosis that is poor compared to other types of colorectal cancers.[ncbi.nlm.nih.gov]
  • Abstract INTRODUCTION Linitis plastica (LP) is a particular subtype of diffuse gastric cancer and is thought to have a very poor prognosis. The operative approach in patients with LP has historically been questioned because of the poor outcomes.[ncbi.nlm.nih.gov]
  • BACKGROUND: Linitis plastica-type gastric carcinoma remains a disease with poor prognosis despite an aggressive surgical approach.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: After primary surgery, GLP showed a poor prognosis without regard to the extent or type of resection. The failure of surgical treatment related mainly to the peritoneal spread of the disease.[ncbi.nlm.nih.gov]
  • If early recognition is to favorably alter prognosis, then awareness of this form of colonic malignancy is essential.[ncbi.nlm.nih.gov]

Etiology

  • (A) CK7 and (B) CK19 staining of percutaneous biopsy of left psoas muscle with tumor cells, confirming metastatic CCA and ruling out alternative malignancies and etiologies.[acgcasereports.gi.org]
  • Etiology LP is generally a sporadic disease but familial cases have been described. Etiology is unknown.[orpha.net]
  • The term, which does not specify the etiology, was first used in 1865 by Brinton, 1 who considered the lesion to be an advanced stage of gastritis, but did not exclude cancer.[jamanetwork.com]
  • Her scrutinizing clinical history and examination negated any systemic conditions; while the discrimination between local etiologies rested upon histopathological confirmation.[ccij-online.org]

Epidemiology

  • A retrospective review of GA patients with LP from the surveillance, epidemiology, and end results database (2004-2009) was performed. 29,440 patients with GA were identified, of whom 948 (3.2%) had LP.[mayoclinic.pure.elsevier.com]
  • A retrospective review of GA patients with LP from the surveillance, epidemiology, and end results database (2004‐2009) was performed. 29,440 patients with GA were identified, of whom 948 (3.2%) had LP.[ingentaconnect.com]
  • Summary Epidemiology Gastric LP accounts for about 10% of all gastric cancers but the exact prevalence in the general population is unknown.[orpha.net]
Sex distribution
Age distribution

Prevention

  • […] circumferential view of the individual layers of the rectum and can detect intramural tumor infiltration even if the overlying mucosa appears normal. 10 Decompressive treatments including diversion colostomy and colonic stenting have been used for the prevention[journals.lww.com]
  • Successful intraperitoneal hyperthermic chemoperfusion for the prevention of postoperative peritoneal recurrence in patients with advanced gastric carcinoma. Cancer 1999 ; 85 : 529 –34. 25.[academic.oup.com]
  • As a result of the CT findings, colonoscopy was attempted but narrowing prevented progress beyond the rectosigmoid junction.[scitechnol.com]
  • An attractive proposition to reduce the incidence of the disease is to identify individuals who are at high risk, and who may benefit from targeted screening and other prophylactic measures to prevent the onset of frank malignancy.[qjmed.oxfordjournals.org]

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