Texas Tech University Health Sciences Center, El Paso El Paso, TX
Akanksha Togra, MD1, Adderly Toribio de Jesus, MD2, Jesus Guzman, MD2, Marc J. Zuckerman, MD2, Sherif E. Elhanafi, MD3 1Texas Tech University Health Sciences Center, El Paso, El Paso, TX; 2Division of Gastroenterology, Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX., El Paso, TX; 3Texas Tech University Health Sciences Center, El Paso, TX Introduction: Linitis Plastica is a rare type of gastric tumor which presents as thickening of gastric wall and submucosal hypertrophy consisting mainly of connective and muscular tissues. Although prevalent in only 3% of the gastric adenocarcinoma cases, it has an aggressive course making an early diagnosis imperative. Here we discuss a particular a misleading case of Linitis Plastica presenting with signs of clinical significant portal hypertension though to be decompensated cirrhosis.
Case Description/
Methods: 54-year-old female with history of chronic gastritis presented for 2 weeks of progressively increasing abdominal distention. She also reported approximately 50 lbs weight loss noticed over 5 months. Initial CT abdomen showed ascites and hepatomegaly. Following MRI abdomen showed diffuse thickening of gastric wall seen especially in the antrum, portal hypertensive pattern including para-umbilical and para-esophageal varices. To interrogate the cause for portal hypertension, a diagnostic paracentesis was performed which showed a SAAG of 0.9, not consistent with portal hypertension but rising the suspicion of an underlying malignancy. Given the previous MRI findings, the patient underwent upper GI endoscopy which showed thickened, non-distensible friable mucosa concerning for diffuse malignant process. Deep cold forceps biopsies were obtained and showed adenocarcinoma with signet ring features confirming the diagnosis of Linitis Plastica. Discussion: Diagnosis of Linitis Plastica can be challenging and warrants high clinical suspicion. Endoscopic examination with deep mucosal biopsies is fundamental, however, if the diagnosis is not established, further tissue acquisition should be considered using EUS guided sampling or a surgical approach.
Disclosures: Akanksha Togra indicated no relevant financial relationships. Adderly Toribio de Jesus indicated no relevant financial relationships. Jesus Guzman indicated no relevant financial relationships. Marc Zuckerman indicated no relevant financial relationships. Sherif Elhanafi indicated no relevant financial relationships.
Akanksha Togra, MD1, Adderly Toribio de Jesus, MD2, Jesus Guzman, MD2, Marc J. Zuckerman, MD2, Sherif E. Elhanafi, MD3. P2124 - Misleading Signs of Portal Hypertension: A Hidden Case of Gastric Linitis Plastica, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
