Fig. 7

Linitis plastica appearance of the stomach and rectum due to metastatic ILC in a 61-year-old female. Six years after completing therapy for Stage 1A ILC of the right breast, she presented with change in bowel habit and a palpable rectal mass on examination. She later developed symptoms of subacute bowel obstruction. a Axial contrast-enhanced CT image shows incidental diffuse, circumferential wall thickening of the stomach (white arrowhead), suggestive of linitis plastica. b Corresponding axial PET/CT demonstrates mild ¹⁸F-FDG-uptake (SUVmax 3.05) in the distal stomach (white arrow). This degree of metabolic uptake was deemed at the upper limit of physiological uptake. Diffuse metastatic involvement of the stomach was confirmed on exploratory laparotomy. c Axial T2-weighted MR image demonstrates circumferential thickening of the rectum, with preserved concentric bowel wall layers (black arrow), giving a “target sign” appearance. d Axial T2-weighted MR image of the pelvic floor shows a near-circumferential, ill-defined, T2-weighted hypointense mass (white arrowhead) around the anal canal (white arrow). Initial biopsies were inconclusive, likely due to the predominantly extramural location of the mass. Metastatic involvement was confirmed on subsequent deep biopsy