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Acute Pancreatitis Revealing Poorly Cohesive Gastric Carcinoma with Secondary Rectal Location: a Case Report

Author: Oussama Lakhdar, Rachid Ardif, Loubna Elrharbaoui, Ihsane El Jaâdi, Houda Meyiz; Ihsane Mellouki

Category: JMSR Gastroenterology


Poorly cohesive gastric carcinoma currently constitutes a full-fledged histological type, defined by a percentage of isolated cells more than 50% dispersed in a fibrous stroma. Its revealing clinical symptomatology is often non-specific. We report the exceptional case of a patient admitted to the emergency department for acute pancreatitis, whose etiological investigation of its cause discovered a poorly cohesive gastric carcinoma with secondary rectal location.

Keywords: Gastric Adenocarcinoma, Gastrointestinal Endoscopy, Pancreatitis, Poorly Cohesive Gastric Carcinoma, Case report

DOI: 10.46327/msrjg.1.000000000000238



  1. Nakamura K, Eto K, Iwagami S, Ogawa K, Sawayama H, Ishimoto T., Iwatsuki M, Baba Y, Miyamoto Y, Yoshida N, & Baba H. Clinicopathological characteristics and prognosis of poorly cohesive cell subtype of gastric cancer. International journal of clinical oncology. 2022; 27(3), 512–519.
  2. Mariette C, Carneiro F, Grabsch H I, van der Post R S, Allum W, de Manzoni G, & European Chapter of International Gastric Cancer Association. Consensus on the pathological definition and classification of poorly cohesive gastric carcinoma. Gastric cancer: official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association.2019; 22(1), 1–9.
  3. Fléjou JF. Classification OMS 2010 des tumeurs digestives: la quatrième édition [WHO Classification of digestive tumors: the fourth edition]. Ann Pathol. 2011;31(5 Suppl):S27-S31.
  4. Piessen G, Messager M, Le Malicot K, Robb WB, Di Fiore F, Guilbert M, Moreau M, Christophe V, Adenis A, Mariette C. Phase II/III multicentre randomised controlled trial evaluating a strategy of primary surgery and adjuvant chemotherapy versus peri-operative chemotherapy for resectable gastric signet ring cell adenocarcinomas - PRODIGE 19 - FFCD1103 - ADCI002. BMC Cancer. 2013; 13: 281.
  5. Drubay V, Nuytens F, Renaud F, Adenis A, Eveno C, Piessen G. Poorly cohesive cells gastric carcinoma including signet-ring cell cancer: Updated review of definition, classification and therapeutic management. World J Gastrointest Oncol. 2022; 14(8): 1406-1428.
  6. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136 (5):E359-86.
  7. Benesch M G K, Bursey S R, O'Connell A C, Ryan M G, Howard C L, Stockley C C, & Mathieson A. CDH1 Gene Mutation Hereditary Diffuse Gastric Cancer Outcomes: Analysis of a Large Cohort, Systematic Review of Endoscopic Surveillance, and Secondary Cancer Risk Postulation. Cancers; 2021; 13(11): 2622.
  8. Machlowska J, Baj J, Sitarz M, Maciejewski R, Sitarz R. Gastric Cancer: Epidemiology, Risk Factors, Classification, Genomic Characteristics and Treatment Strategies. Int J Mol Sci. 2020; 21 (11): 4012.
  9. Kwack W, Ho W, Kim H, Lee H, Kim J, Kang W, & Lee K. Understanding the diagnostic yield of current endoscopic biopsy for gastric neoplasm: A prospective single-center analysis based on tumor characteristics stratified by biopsy number and site. Medicine. 2016 ; 95(30), e4196.
  10. Henrion J, De Néve A, Sergent H, Schmitz A, Heller F. Linite plastique primitive du rectum et du colon : Rapport d’un cas et revue de la littérature. Gastroenterol Clin Biol.2002; 8: 8
  11. Yamauchi H, Sakurai S, Hagiwara K, Yoshida T, Tabe Y, Fukasawa T, Kiriyama S, Fukuchi M, Naitoh H, Kuwano H. Poorly cohesive adenocarcinoma of the ampulla of Vater: a case report. Surg Case Rep. 2016 Dec;2(1):15.
  12. Ushida Y, Hiramatsu K, Saeki S, Amemiya T, Goto H, Arai T. Poorly differentiated adenocarcinoma with signet-ring cells in duodenal papilla: a case report. Surg Case Rep. 2017;3(1):14.
  13. Chen J, Zhou C, He M, Zhen Z, Wang J, Hu X. A Meta-Analysis and Systematic Review Of Accuracy Of Endoscopic Ultrasound For N Staging Of Gastric Cancers. Cancer Manag Res. 2019; 11: 8755-8764.
  14. Zhang M, Zhu G, Zhang H, Gao H, Xue Y. Clinicopathologic features of gastric carcinoma with signet ring cell histology. J Gastrointest Surg. 2010; 14(4): 601-606.
  15. Boustani J, Kim S, Lescut N, Lakkis Z, de Billy M, Arbez-Gindre F, Jary M, Borg C, Bosset JF. Primary Linitis Plastica of the Rectum: Focus on Magnetic Resonance Imaging Patterns and Treatment Options. Am J Case Rep. 2015; 16: 581-5.
  16. Drubay V, Nuytens F, Renaud F, Adenis A, Eveno C, Piessen G. Poorly cohesive cells gastric carcinoma including signet-ring cell cancer: Updated review of definition, classification and therapeutic management. World J Gastrointest Oncol. 2022 Aug
  17. Jafferbhoy S, Shiwani H, Rustum Q. Managing Gastric Linitis Plastica: Keep the scalpel sheathed. Sultan Qaboos Univ Med J. 2013; 13(3):451-453.
  18. Chon HJ, Hyung WJ, Kim C, Park S, Kim JH, Park CH, Ahn JB, Kim H, Chung HC, Rha SY, Noh SH, Jeung HC. Differential Prognostic Implications of Gastric Signet Ring Cell Carcinoma: Stage Adjusted Analysis from a Single High-volume Center in Asia. Ann Surg. 2017; 265(5): 946-953.
  19. Jouini R, Khanchel F, Sabbah M, Helal I, Gharsallah A, Ferchichi M, Hadded D, Zaafouri H, Ben Brahim E, Ben Maamer A, Debbiche AC. Prognostic significance of poorly cohesive gastric carcinoma in Tunisian patients. Heliyon. 2020; 6(3): e03460.