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©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
Computed tomography and magnetic resonance imaging findings of metastatic rectal linitis plastica from prostate cancer: A case report and review of literature
Jin Hee You, Ji Soo Song, Kyu Yun Jang, Min Ro Lee
Jin Hee You, Ji Soo Song, Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Chonbuk, South Korea
Ji Soo Song, Research Institute of Clinical Medicine of Chonbuk National University, Jeonju 54907, Chonbuk, South Korea
Ji Soo Song, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju 54907, Chonbuk, South Korea
Kyu Yun Jang, Department of Pathology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Chonbuk, South Korea
Min Ro Lee, Department of Surgery, Chonbuk National University Medical School and Hospital, Jeonju 54907, Chonbuk, South Korea
Author contributions: You JH and Song JS wrote the manuscript. Jang KY performed the pathological examination; Lee MR performed excisional biopsy; Jang KY and Lee MR edited the manuscript.
Informed consent statement: The study was performed after obtaining the patient’s informed consent. The patient was treated according to the provisions of the Helsinki criteria.
Conflict-of-interest statement: Jin Hee You, Ji Soo Song, Kyu Yun Jang, and Min Ro Lee declare no conflicts of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ji Soo Song, MD, PhD, Assistant Professor, Doctor, Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Chonbuk, South Korea. pichgo@jbnu.ac.kr
Telephone: +82-63-2501150 Fax: +82-63-2720481
Received: June 29, 2018
Peer-review started: July 2, 2018
First decision: July 24, 2018
Revised: August 3, 2018
Accepted: August 28, 2018
Article in press: August 28, 2018
Published online: October 26, 2018
Linitis plastica is a rare condition showing circumferentially infiltrating intramural anaplastic carcinoma in a hollow viscus, resulting in a tissue thickening of the involved organ as constricted, inelastic, and rigid. While most secondary rectal linitis plastica (RLP) is caused by metastasis from stomach, breast, gallbladder, or bladder cancer, we report an extremely rare and unique case of secondary RLP due to prostate cancer with computed tomography (CT) and magnetic resonance imaging (MRI) findings, including diffusion weighted imaging (DWI). A 78-year-old man presented with approximately a 2-mo history of constipation and without cancer history. On sigmoidoscopy, there was a luminal narrowing and thickening of rectum with mucosa being grossly normal in its appearance. On contrast-enhanced CT, marked contrast enhancement with wall thickening of rectum was noted. On pelvic MRI, rectal wall thickening showed a target sign on both T2-weighted imaging and DWI. A diffuse infiltrative lesion was suspected in the prostate gland based on low signal intensity on T2-weighted imaging and restricted diffusion. A transanal full-thickness excisional biopsy revealed metastasis from a prostate adenocarcinoma invading the submucosa to the muscularis propria consistent with metastatic RLP. We would like to emphasize the CT and MRI findings of metastatic RLP due to prostate cancer.
Core tip: Secondary rectal linitis plastica (RLP) from prostate cancer is extremely rare. A target sign on T2-weighted imaging and diffusion weighted imaging is characteristic for RLP. The presence of elevated serum prostate specific antigen, T2 low signal intensity, and low apparent diffusion coefficient value lesion on prostate should raise the suspicion of secondary RLP from prostate adenocarcinoma. For confirmative diagnosis, full-thickness excisional biopsy is required due to its characteristic mucosal sparing.
