SHM Converge Scientific Abstract ePoster Gallery-Malignant Dysphagia Due to Linitis Plastica

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This case describes a rare malignant cause of dysphagia and weight loss due to linitis plastica, also called “leather bottle” stomach. Linitis plastica occurs when tumor cells diffusely infiltrate the gastric wall, making it rigid and poorly distensible. Although it is most commonly linked to primary gastric cancer, it can also result from spread of other cancers, including breast, colon, ovarian, and, in this case, likely anogenital or recurrent cervical cancer.<br /><br />A 73-year-old woman with a history of cervical carcinoma in remission presented with three months of progressive dysphagia to both solids and liquids, poor oral intake, early satiety, epigastric/chest discomfort after swallowing, weight loss, fatigue, weakness, and night sweats. On exam, she appeared malnourished and dehydrated, with temporal wasting, dry mucous membranes, hypotension, mild abdominal distention, and epigastric tenderness.<br /><br />CT imaging showed bilateral hydronephrosis, uterine and bladder masses, and a peritoneal implant near the stomach. Upper endoscopy revealed diffuse inflamed, friable, eroded, and ulcerated gastric mucosa suspicious for linitis plastica. Biopsies from the stomach and bladder showed poorly differentiated p16-positive squamous cell carcinoma, likely of anogenital origin, though it was unclear whether this represented recurrent cervical cancer or a new genitourinary primary. She was started on palliative paclitaxel and carboplatin, with some improvement in dysphagia.<br /><br />The report emphasizes that linitis plastica often involves deeper gastric layers while sparing the mucosa, which can make diagnosis difficult and lead to non-diagnostic biopsies. Endoscopic ultrasound and imaging may help. Because it usually reflects advanced, aggressive disease, prognosis is poor.

Asset Subtitle

Arkadiy Finn

Meta Tag

Author List Arkadiy Finn

Category Clinical Vignettes

Concept Linitis Plastica

Concept Gastric Malignancy

Concept Gastric Wall Distensibility

Concept Leather Bottle Stomach

Concept Esophageal Cancer

Distinguished Non-Finalist

Presenter Organization The Miriam Hospital, Warren Alpert Medical School at Brown University

Presenting Author Arkadiy Finn

Track Adult

Keywords

linitis plastica

dysphagia

weight loss

gastric cancer

cervical carcinoma

anogenital squamous cell carcinoma

gastric wall infiltration

endoscopy

palliative chemotherapy

poor prognosis

Linitis Plastica

Gastric Malignancy

Gastric Wall Distensibility

Leather Bottle Stomach

Esophageal Cancer