Infiltrative gastric adenocarcinoma (linitis plastica) with carcinomatosis

Case contributed by Michael P. Hartung
Diagnosis almost certain

Presentation

Abdominal pain, anemia.

Patient Data

Age: 60 years
Gender: Male

Diffuse thickening, irregularity, and enhancement of the gastric body with some nodularity extending into the gastrohepatic ligament. Left upper abdominal omental cake. Thickening of the mesentery. Large ascites. 

Case Discussion

While the gastric wall thickening and hyperenhancement could be initially confused with gastritis, the supporting findings of carcinomatosis (left abdominal omental cake, mesenteric coating, large ascites) raise the suspicion considerably for infiltrative gastric adenocarcinoma (linitis plastica). Additionally, notice how the gastric thickening and enhancement is beyond the mucosal layer and extends well into the muscularis layer, particularly on the coronal reformats near the fundus (indicating tumor infiltration). 

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