Secondary rectal linitis plastica as first manifestation of urinary bladder carcinoma.
Secondary rectal linitis plastica is a very rare malignancy with poor prognosis. Diagnosis is difficult because of nonspecific clinical and endoscopic findings and negative biopsies in most cases owing to the fact that the mucosa is frequently unaffected. We herein describe a 68-year-old man who presented with a six-month history of tenesmus and constipation. Endoscopy revealed a narrow distal rectum with an indurated, cobblestone appearance of mucosa. Multiple biopsies and fine-needle aspiration were negative for malignancy. Abdominal MRI and transrectal ultrasonography showed findings compatible with rectal linitis plastica. He underwent rectal extirpation with total cystectomy and lymph nodes dissection. Histology demonstrated secondary rectal linitis plastica due to a poorly differentiated urinary bladder carcinoma. We emphasize the endoscopic and endosonographic features and the difficulty to establish a preoperative diagnosis of secondary rectal linitis plastica.
Department of Endoscopy and Motility Unit (Panagiotis Katsinelos, Grigoris Chatzimavroudis, Taxiarchis Katsinelos, Eleni Dimou, Athanasios Beltsis, Sotiris Terzoudis, Eustathios Kamperis, Georgia Lazaraki).
Panagiotis
P
Katsinelos
2 Surgical Department (Basilis Papaziogas, Grigoris Chatzimavroudis, Stefanos Atmatzidis), Medical School, Aristotle University of Thessaloniki, G. Gennimatas General Hospital, Thessaloniki, Greece.
Basilis
B
Papaziogas
Department of Endoscopy and Motility Unit (Panagiotis Katsinelos, Grigoris Chatzimavroudis, Taxiarchis Katsinelos, Eleni Dimou, Athanasios Beltsis, Sotiris Terzoudis, Eustathios Kamperis, Georgia Lazaraki) ; 2 Surgical Department (Basilis Papaziogas, Grigoris Chatzimavroudis, Stefanos Atmatzidis), Medical School, Aristotle University of Thessaloniki, G. Gennimatas General Hospital, Thessaloniki, Greece.
Grigoris
G
Chatzimavroudis
Department of Endoscopy and Motility Unit (Panagiotis Katsinelos, Grigoris Chatzimavroudis, Taxiarchis Katsinelos, Eleni Dimou, Athanasios Beltsis, Sotiris Terzoudis, Eustathios Kamperis, Georgia Lazaraki).
Taxiarchis
T
Katsinelos
Department of Endoscopy and Motility Unit (Panagiotis Katsinelos, Grigoris Chatzimavroudis, Taxiarchis Katsinelos, Eleni Dimou, Athanasios Beltsis, Sotiris Terzoudis, Eustathios Kamperis, Georgia Lazaraki).
Eleni
E
Dimou
2 Surgical Department (Basilis Papaziogas, Grigoris Chatzimavroudis, Stefanos Atmatzidis), Medical School, Aristotle University of Thessaloniki, G. Gennimatas General Hospital, Thessaloniki, Greece.
Stefanos
S
Atmatzidis
Department of Endoscopy and Motility Unit (Panagiotis Katsinelos, Grigoris Chatzimavroudis, Taxiarchis Katsinelos, Eleni Dimou, Athanasios Beltsis, Sotiris Terzoudis, Eustathios Kamperis, Georgia Lazaraki).
Athanasios
A
Beltsis
Department of Endoscopy and Motility Unit (Panagiotis Katsinelos, Grigoris Chatzimavroudis, Taxiarchis Katsinelos, Eleni Dimou, Athanasios Beltsis, Sotiris Terzoudis, Eustathios Kamperis, Georgia Lazaraki).
Sotiris
S
Terzoudis
Department of Endoscopy and Motility Unit (Panagiotis Katsinelos, Grigoris Chatzimavroudis, Taxiarchis Katsinelos, Eleni Dimou, Athanasios Beltsis, Sotiris Terzoudis, Eustathios Kamperis, Georgia Lazaraki).
Eustathios
E
Kamperis
Department of Endoscopy and Motility Unit (Panagiotis Katsinelos, Grigoris Chatzimavroudis, Taxiarchis Katsinelos, Eleni Dimou, Athanasios Beltsis, Sotiris Terzoudis, Eustathios Kamperis, Georgia Lazaraki).
Georgia
G
Lazaraki
secondary rectal linitis plastica; urinary bladder carcinoma