A Case of Ileus due to Linitis Plastica Type Carcinoma of Transverse Colon

Abstract

A 59-year-old man with a history of distal gastrectomy with D₂ dissection for type IIc gastric cancer 6 years earlier admitted for abdominal pain. The gastric cancer was resected surgically. Pathological findings of resected specimen were P₀, H₀, n₀, ly₀, v₀, and m, poorly differentiated adenocarcinoma with signet-ring cell carcinoma. So, no adjuvant chemotherapy was done. On admission, dilatation of colon was found in the abdominal X ray film Barium enema radiography showed a stenotic change in the transeverse colon. Colonoscopy showed severe stenosis and a mucosal surface was reddish and edematous. Histological examination of the biopsy specimen showed no malignant tissue. We resected the transverse colon surgically, but no definite peritoneal dissemination was found. Pathological findings of the transverse colon showed poorly differentiated adenocarcinoma invading from the submucosa to subserosa with severe fibrosis but no carcinoma invasion to the mucosal layer. We thought this stenotic leisions was metastatic colonic cancer. Both primary gastric cancer and the colonic lesion were similar to histological findings and immunohistochemical staining, but we could not exclude this case as primary colon cancer absolutely.