Primary Rectal Linitis Plastica: Report of Two Cases and Literature Review

Background: Linitis plastica is classically described in the stomach, characterized by a diffuse infiltrative growth pattern and poor prognosis. Primary rectal involvement is extremely rare. Case presentation: We report two cases of primary rectal linitis plastica diagnosed at Hassan II University Hospital of Fez. Both patients presented with rectal syndrome and weight loss. Imaging revealed circumferential rectal wall thickening. Histopathology confirmed poorly differentiated adenocarcinoma with signet-ring cells. Despite neoadjuvant chemoradiotherapy, the tumors were deemed unresectable, and both patients were referred for palliative chemotherapy. Conclusion: Primary rectal linitis plastica is a rare but aggressive malignancy. Diagnosis requires deep biopsies and exclusion of secondary involvement. Prognosis remains poor due to late presentation and limited therapeutic options.