Primary linitis plastica carcinoma of the colon accompanied by peritoneal abscess

We describe the case of a 75-year-old woman with linitis plastica carcinoma of the colon, accompanied by a peritoneal abscess, in which the use of transabdominal sonography enabled prompt detection and diagnosis. Sonographic examinations revealed diffuse wall thickening with blurred layer stratification in the ascending colon. The irregular outer margin of the affected area was surrounded by thickened pericolic fat. A peritoneal abscess covered by the omentum was also found. CT confirmed these findings. We extensively resected the right half of the colon. Histopathologic examination of the excised segment of the colon revealed a poorly differentiated adenocarcinoma with fibrotic infiltration. The patient was discharged 6 weeks postoperatively, and chemotherapy was begun, but she was lost to our follow-up. Although linitis plastica carcinoma of the colon is rare, it must be considered when patients have extensive colonic wall thickening with blurred layer stratification and an irregular outer margin surrounded by thickened pericolic fat. Transabdominal sonography should be considered the imaging modality of choice for the detection and diagnosis of this disease entity. (C) 2003 Wiley Periodicals, Inc.