Scirrhous carcinoma of the gastrointestinal tract is a subtype of primary adenocarcinoma of the gastrointestinal (GI) tract.
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Epidemiology
It is the least common type of primary adenocarcinoma involving mainly the stomach and the colon.
Pathology
The tumor demonstrates an infiltrative behavior, which instead of forming a bulky mass, rather causes thickening and stiffening of the intestinal wall with foreshortening, luminal stenosis, rigidity and lack of peristaltic activity (linitis plastica).
Radiographic features
Conventional fluoroscopy (barium studies) / CT
Stomach
- focal or circumferential segments of wall thickening (1-3 cm)
- luminal narrowing with gradual transition into a normal-appearing segment of bowel
- homogeneous enhancement
- may show intramural calcifications
- may lead to obstruction with proximal dilation
- progressive tapering of stomach lumen diameter from the antrum to the pylorus (ram's horn antrum)
Colon
- similar findings, but less specific, since other inflammatory lesions with similar appearances are more frequent in the colon
Treatment and prognosis
This subtype has the poorest prognosis and lowest survival rate of all gastrointestinal tract adenocarcinomas due to rapid growth and early metastasis.