PRIMARY LINITIS PLASTICA CARCINOMA OF THE COLON AND RECTUM

Primary linitis plastica of the colon or rectum is a rare entity. Only 85 cases of this type cancer have been reported in the English medica l literature. We report two cases, including the oldest known patient presenting uniquely with a sigmoid volvulus and another patient presen ting with fecal incontinence and perianal pain. Linitis plastica of th e colon or rectum is characterized by presentation in younger patients and is associated with metastatic disease, a high mortality, and insi dious growth, often making detection difficult. A high degree of suspi cion must therefore be held; a low threshold for endoscopic and echoen doscopic diagnostic intervention also should be maintained. Endoscopic ultrasound provides a unique view of its circumferential infiltrating pattern for diagnosis and staging, but further experience is necessar y to establish whether the early use of endoscopic ultrasound favorabl y impacts mortality.