Gisela G. Oropeza-Rodríguez, Servicio de Coloproctología, Unidad de Fisiología Anorrectal, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Eduardo Alvarado-Tamez, Jefatura del Servicio de Coloproctología, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jal., México
Jeziel Ordóñez-Juárez, Jefatura del Servicio de Coloproctología, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jal., México
Bertha Dimas-Sánchez, Jefatura del Servicio de Coloproctología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Paul E. Solís-Hidalgo, Servicio de Coloproctología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Juan A. Villanueva-Herrero, Unidad de Fisiología Anorrectal, Servicio de Coloproctología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Billy Jiménez-Bobadilla, Jefatura del Servicio de Coloproctología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Primary rectal linitis plastica is an uncommon oncological presentation, accounting for less than 0.1% of rectal tumors. Its pathophysiology is characterized by submucosal infiltration of malignant epithelial cells accompanied by an intense desmoplastic reaction, resulting in marked rectal wall rigidity that implies significant challenges for both clinical and histopathological diagnosis. We report the case of a 41-year-old man presenting with anal pain, tenesmus, hematochezia, and progressive weight loss. Imaging studies demonstrated concentric circumferential thickening of the rectal wall with significant luminal narrowing, without evidence of lymphadenopathy or involvement of adjacent organs. Initial endoscopic biopsies were inconclusive; however, a full-thickness macrobiopsy of the rectum confirmed a poorly differentiated adenocarcinoma composed of 75% signet-ring cell component and 25% mucinous component. The patient underwent abdominoperineal resection, with pathological analysis revealing tumor infiltration extending into the mesorectal fascia and lymphovascular invasion with lymph node metastases. Primary rectal linitis plastica remains a rare condition that should be considered in patients with suggestive clinical and radiological findings. Its confirmation requires deep tissue sampling to establish the histological diagnosis and to guide appropriate therapeutic management.
Keywords: Diverticulitis. Abdominoperineal resection. Anus neoplasms. Endosonography. Constipation. Colonoscopy.