Abstract
Purpose
Intussusception is a recognised but unusual presenting feature of Burkitt lymphoma. We sought to identify the clinical features associated with intussusception in this setting, and assess the outcome following protocol directed chemotherapy.
Methods
A retrospective case note review was performed on patients treated for Burkitt lymphoma at our institution between 1976 and 2010. Cases presenting with intussusception were identified from hospital records and oncology database.
Results
Fourteen of the 210 children seen with a diagnosis of Burkitt lymphoma during the study period (6.7%) developed intussusception. Median age was 6.1 years (range 2.5–10.9). Twelve patients presented with recurrent abdominal pain, and two patients with a jaw mass associated with endemic Burkitt lymphoma. Nine patients underwent a right hemicolectomy with ileo-colic anastomosis, and five had segmental small-bowel resections. Three patients had bone marrow involvement at diagnosis, two of whom died. All patients received chemotherapy. Median follow-up was 6.07 years (range 0.1–28.8).
Conclusions
Small bowel lymphoma should be considered in children presenting with intussusception above the normal infantile peak age range. The presentation is often insidious, and complete obstruction may not be apparent. However, when surgically resected, the majority can achieve a good outcome with additional chemotherapy.
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References
Shamberger RC, Weinstein HJ (1992) The role of surgery in abdominal Burkitt lymphoma. J Pediatr Surg 27:236–240
Attarbaschi A, Mann G, Dworzak M et al (2002) The role of surgery in the treatment of pediatric B-cell non-Hodgkin lymphoma. J Pediatr Surg 37:1470–1475
Gahukamble DB, Kharnage AS (1995) Limitations of surgery in intraabdominal Burkitt lymphoma in children. J Pediatr Surg 30:519–522
Stefan DC, Stones D, Newton R (2011) Burkitt lymphoma in South African children: one or two entities? Transfus Apher Sci 44:191–194
Davidson A, Desai F, Hendricks M et al (2006) The evolving management of Burkitt lymphoma at Red Cross Children’s Hospital. S Afr Med J 96:950–954
Wayne ER, Campbell JB, Kosloske AM et al (1976) Intussusception in the older child-suspect lymphosarcoma. J Pediatr Surg 11:789–794
Gupta H, Davidoff AM, Pui CH (2007) Clinical implications and surgical management of intussusception in pediatric patients with Burkitt lymphoma. J Pediatr Surg 42:998–1001
Hassani KIM, El bouhaddouti H, Ousadden A et al (2010) Non-Hodgkin lymphoma revealed by an ilio-colic intussusception in a Moroccan patient: a case report. Pan Afr Med J 4:11
Moore SW, Kirsten M, Muller EW et al (2010) Retrospective surveillance of intussusception in South Africa, 1998–2003. J Infect Dis 202:S156–S161
Vural S, Baskin D, Dogan Ö et al (2010) Diagnosis in childhood abdominal Burkitt lymphoma. Ann Surg Oncol 17:2476–2479
Kemeny MM, Magrath IT, Brennan MF (1982) The role of surgery in the management of American Burkitt lymphoma and its treatment. Ann Surg 196:82–86
LaQuaglia MP, Stolar CJH, Krailo M et al (1992) The role of surgery in abdominal non-Hodgkin lymphoma: experience from the Children’s Cancer Study Group. J Pediatr Surg 27:230–236
Metzelder ML, Kuebler JF, Shimotakahara A et al (2007) Role of diagnostic and ablative minimally invasive surgery for pediatric malignancies. Cancer 109:2343–2348
Acknowledgments
The authors are grateful for the diligence of their colleagues in the Department of Paediatric Oncology in maintaining a long term registry that has made this study possible.
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England, R.J., Pillay, K., Davidson, A. et al. Intussusception as a presenting feature of Burkitt lymphoma: implications for management and outcome. Pediatr Surg Int 28, 267–270 (2012). https://doi.org/10.1007/s00383-011-2982-5
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DOI: https://doi.org/10.1007/s00383-011-2982-5