Linites gastriques

Linitis plastica is a unique malignancy classified among infiltrating tumors. Linitis of the stomach massively infiltrates the gastric wall without disrupting its architecture. Foci of carcinomatous lymphangitis, lymph node involvement, and perotoneal metastases are common. The cells frequently exhibit a signet-cell appearance, and linitis is the most common and most severe form of signet-cell cancer. Linitis contributes 5 to 10% of all stomach cancers. There are no known risk factors, and few molecular biology data are available. Clinical symptoms provide little orientation. Endoscopy shows a tubular rigid stomach. The biopsies can be negative. Barium study findings are often suggestive. Endoscopic ultrasonography remains the best investigation, since it is positive in over 95% of cases, capable of demonstrating early or localized forms, and helpful for monitoring therapy. Extensive surgery remains the standard therapeutic approach and can be curative. Prolonged administration of 5FU or its precursors combined with CDDP has been proven effective. Median survival after excision is around 18 months.