1
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Attard TM, Omar U, Glynn EF, Stoecklein N, St Peter SD, Thomson MA. Gastric cancer in the pediatric population, a multicenter cross-sectional analysis of presentation and coexisting comorbidities. J Cancer Res Clin Oncol 2023; 149:1261-1272. [PMID: 35435488 DOI: 10.1007/s00432-022-03972-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/22/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Solid tumors of the stomach in children are rare, adenocarcinoma being most frequently reported. Risk factors and clinical presentation are poorly understood. We undertook a nationwide database analysis to evaluate pediatric CA stomach presentation, comorbidities, and metastatic pattern. METHODS The Cerner Health Facts Database® (CHFD) was queried for pediatric age range (1-21) patients, 2010-2017 inclusive. The pediatric gastric cancer cohort was defined by ICD9 and ICD 10 CM diagnoses attributable to primary (non-GIST, non-hematologic) solid tumors of the stomach limited to diagnosis priority < 5 and validated by filtering for supportive diagnoses. Demographic characteristics, comorbidities, before and throughout the medical record were analyzed and compared to the base population. RESULTS The cohort included 333 patients from a base population of 9.6 million children. The M:F ratio was 1.15:1, mean age at diagnosis was 11.8 years. Stomach cancer was most prevalent in non-Hispanic whites, less in Asians and African Americans. Symptoms included abdominal pain, vomiting, anemia, diarrhea and weight loss. Reflux symptoms, esophagitis, gastritis, including H. pylori and duodenitis were reported in 10.2%. Obesity, obesity-related comorbidities, tobacco exposure and family history of colonic polyps, gastrointestinal and breast cancer were all more prevalent (P < 0.0001) in the cohort. DISCUSSION We defined patient demographic characteristics, anatomic distribution in a large cohort of children with solid tumors of the stomach. Reported symptoms in our cohort are similar to those observed in adults. Associated comorbidities which may reflect risk factors include obesity, tobacco exposure and family history of intestinal polyps and malignancy.
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Affiliation(s)
- Thomas M Attard
- University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO, 64108, USA. .,Division of Gastroenterology, Hepatology and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA.
| | - Uraizee Omar
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO, USA
| | - Earl F Glynn
- Children's Mercy Research Institute, Kansas City, MO, USA
| | - Nicole Stoecklein
- Division of Gastroenterology, Hepatology and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Shawn D St Peter
- Department of Surgery, Children's Mercy Hospital, Kansas City, MO, USA
| | - Mike A Thomson
- Department of Paediatric Gastroenterology, Sheffield Children's Hospital NHS Foundation Trust, Sheffield University, Sheffield, South Yorkshire, UK
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2
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Epidemiology and Characteristics of Gastric Carcinoma in Childhood-An Analysis of Data from Population-Based and Clinical Cancer Registries. Cancers (Basel) 2023; 15:cancers15010317. [PMID: 36612313 PMCID: PMC9818931 DOI: 10.3390/cancers15010317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023] Open
Abstract
(1) Background: Gastric carcinoma is an exceptionally rare tumor in childhood. Little is known about the etiology, epidemiology, and clinical features of pediatric gastric carcinomas. This analysis aimed to fill this gap by increasing knowledge about the occurrence of gastric carcinoma in childhood. (2) Material and methods: Data from gastric carcinoma cases diagnosed between 2000 and 2017/2018 were retrieved from the Surveillance, Epidemiology, and End Results Program (SEER) and the German Center for Cancer Registry Data. Data from patients <20 years of age were analyzed for patient- and tumor-related characteristics. In addition, clinical data from patients with gastric carcinoma registered in the German Registry for Rare Pediatric Tumors (STEP) were analyzed for diagnostics, therapy, and outcome. (3) Results: Ninety-one cases of gastric carcinoma, mainly in adolescents, were identified in the epidemiologic cancer registries. Among patients with recorded staging data, advanced tumor stages were common (66.7%). Within the follow-up period covered, 63.7% of patients with clinical follow-up data died. Eight pediatric patients with gastric carcinoma were enrolled in the STEP registry, among whom two were patients with hereditary CDH1 mutations and another was a patient with Peutz−Jeghers syndrome. Three patients were found to have distinctly decreased immunoglobulin concentrations. All four patients in whom complete resection was achieved remained in remission. Three of the other four patients died despite multimodal therapy. (4) Conclusions: A combination of Helicobacter pylori infection and tumor predisposition and/or immunodeficiency appears to promote the development of gastric carcinoma in childhood. While patients with localized disease stages have a good chance of achieving durable remission through complete resection, patients with stage IV carcinomas face a dismal prognosis, highlighting the need to develop new strategies such as mutation-guided treatments.
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3
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Witt L, Pillay Y, Sabaratnam RM, Bigsby RJ. De novo adolescent gastric carcinoma: a first case report in Saskatchewan, Canada. J Surg Case Rep 2020; 2020:rjaa249. [PMID: 32855800 PMCID: PMC7442919 DOI: 10.1093/jscr/rjaa249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/19/2020] [Indexed: 11/13/2022] Open
Abstract
Adolescent gastric cancers are extremely rare with a reported incidence of 0.05-0.10% in North America. We present a de novo case of gastric carcinoma in a 17-year-old teenager with no concomitant family history or risk factors. His main clinical presentation included anaemia and melaena stools. Despite an extensive clinical workup that included a diagnostic laparoscopy, the tumour was deemed surgically irresectable, and he was started on a palliative chemotherapy protocol at the local paediatric oncology centre. He demised 7 months later. This is the first recorded case of an adolescent gastric cancer in Saskatchewan, Canada. This case highlights the need for an international tumour registry to document and investigate rare adolescent gastric malignancies and thereby potentiate a possible cure through the pooling of limited resources.
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Affiliation(s)
- Lara Witt
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Yagan Pillay
- Department of Surgery, University of Saskatchewan, Victoria Hospital, Prince Albert, SK, Canada
| | - Rathi M Sabaratnam
- Department of Pathology and Laboratory Medicine, Victoria Hospital, Prince Albert, SK, Canada
| | - Richard J Bigsby
- Department of Thoracic Surgery, University of Saskatchewan, Saskatoon, SK, Canada
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4
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Alexander KL, Serrano CA, Chakraborty A, Nearing M, Council LN, Riquelme A, Garrido M, Bellis SL, Smythies LE, Smith PD. Modulation of glycosyltransferase ST6Gal-I in gastric cancer-derived organoids disrupts homeostatic epithelial cell turnover. J Biol Chem 2020; 295:14153-14163. [PMID: 32763973 DOI: 10.1074/jbc.ra120.014887] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/05/2020] [Indexed: 12/24/2022] Open
Abstract
Programmed cell death promotes homeostatic cell turnover in the epithelium but is dysregulated in cancer. The glycosyltransferase ST6Gal-I is known to block homeostatic apoptosis through α2,6-linked sialylation of the death receptor TNFR1 in many cell types. However, its role has not been investigated in gastric epithelial cells or gastric tumorigenesis. We determined that human gastric antral epithelium rarely expressed ST6Gal-I, but the number of ST6Gal-I-expressing epithelial cells increased significantly with advancing premalignancy leading to cancer. The mRNA expression levels of ST6GAL-I and SOX9 in human gastric epithelial cells correlated positively with one another through the premalignancy cascade, indicating that increased epithelial cell expression of ST6Gal-I is associated with premalignant progression. To determine the functional impact of increased ST6Gal-I, we generated human gastric antral organoids from epithelial stem cells and differentiated epithelial monolayers from gastric organoids. Gastric epithelial stem cells strongly expressed ST6Gal-I, suggesting a novel biomarker of stemness. In contrast, organoid-derived epithelial monolayers expressed markedly reduced ST6Gal-I and underwent TNF-induced, caspase-mediated apoptosis, consistent with homeostasis. Conversely, epithelial monolayers generated from gastric cancer stem cells retained high levels of ST6Gal-I and resisted TNF-induced apoptosis, supporting prolonged survival. Protection from TNF-induced apoptosis depended on ST6Gal-I overexpression, because forced ST6Gal-I overexpression in normal gastric stem cell-differentiated monolayers inhibited TNF-induced apoptosis, and cleavage of α2,6-linked sialic acids from gastric cancer organoid-derived monolayers restored susceptibility to TNF-induced apoptosis. These findings implicate up-regulated ST6Gal-I expression in blocking homeostatic epithelial cell apoptosis in gastric cancer pathogenesis, suggesting a mechanism for prolonged epithelioid tumor cell survival.
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Affiliation(s)
- Katie L Alexander
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Carolina A Serrano
- Departments of Pediatric Gastroenterology and Nutrition, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Asmi Chakraborty
- Department of Cell Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Marie Nearing
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Leona N Council
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Arnoldo Riquelme
- Department of Gastroenterologys, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department Health Sciences, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Marcelo Garrido
- Department of Oncology, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Susan L Bellis
- Department of Cell Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lesley E Smythies
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Phillip D Smith
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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5
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Abstract
Background Primary gastric adenocarcinoma commonly occurs in the elderly in the sixth to seventh decade of life but is exceedingly rare in children and adolescents, accounting for only 0.05% of pediatric gastrointestinal malignancies. Because of the nonspecific clinical presentation, gastric adenocarcinomas in children and adolescents are often metastatic when they are discovered. Case Report We describe a case of gastric adenocarcinoma in a 16-year-old female who was diagnosed early and successfully treated with surgery and chemoradiation by volumetric modulated arc technique. Conclusion The possibility of gastric adenocarcinoma should be considered in children and adolescents with persistent nonspecific symptoms of vomiting and upper abdominal pain so that the diagnosis can be made at early stages and radical treatment can be offered.
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6
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Sabree S, Berg D, Sato M. Treatment of a pediatric patient with MET-amplified signet ring cell adenocarcinoma of the stomach with crizotinib. Pediatr Blood Cancer 2018; 65:e26984. [PMID: 29380521 DOI: 10.1002/pbc.26984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/25/2017] [Accepted: 12/27/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Shakoora Sabree
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Daniel Berg
- Department of Internal Medicine, University of Iowa Hospital and Clinics, Iowa City, Iowa
| | - Mariko Sato
- Department of Pediatric Hematology Oncology, Stead Family Children's Hospital, University of Iowa, Iowa City, Iowa
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7
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Indini A, Bisogno G, Cecchetto G, Vitellaro M, Signoroni S, Massimino M, Riccipetitoni G, Zecca M, Dall'Igna P, De Pasquale MD, Inserra A, Chiaravalli S, Basso E, Virgone C, Sorbara S, Di Bartolomeo M, D'Angelo P, Ferrari A. Gastrointestinal tract carcinoma in pediatric and adolescent age: The Italian TREP project experience. Pediatr Blood Cancer 2017; 64. [PMID: 28561949 DOI: 10.1002/pbc.26658] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/03/2017] [Accepted: 05/08/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Gastrointestinal (GI) carcinomas are very rare in the pediatric and adolescent age range. We report the clinical features, treatment, and outcome of a series of children and adolescents with GI carcinoma prospectively registered in the Italian Tumori Rari in Età Pediatrica (TREP) project. METHODS The TREP project developed diagnostic and therapeutic guidelines based on recommendations currently in use for adults. Clinical data were centrally registered and reviewed. RESULTS Fifteen patients were registered over the years 2000-2016. Most of the tumors were colorectal carcinomas (12 cases). All but one patient had advanced-stage disease (American Joint Committee on Cancer stages III-IV), and the majority of patients had aggressive histological subtypes, i.e. poorly differentiated (G3) (five patients), mucinous (four patients), and signet ring (two patients) adenocarcinomas. Surgery was performed in 13 of 15 patients, and was radical in nine of 13 patients. Only one patient received postoperative radiotherapy. All patients received chemotherapy, with the addition of bevacizumab in two cases. Nine patients were still alive at the time of the present report, but two of them had only just completed their treatment program and one patient is still on treatment. Six patients died due to disease progression. CONCLUSIONS This prospective report on pediatric GI tract carcinomas confirms the rarity and biological aggressiveness of these diseases in pediatric and adolescent age. Further prospective studies are needed to explore the distinct biology of tumor in this age group in order to find new therapeutic targeted agents.
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Affiliation(s)
- Alice Indini
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Gianni Bisogno
- Hematology-Oncology Division, Department of Pediatrics, Padova University Hospital, Padova, Italy
| | - Giovanni Cecchetto
- Division of Pediatric Surgery, Department of Pediatrics, Padova University Hospital, Padova, Italy
| | - Marco Vitellaro
- Unit of Hereditary Digestive Tract Tumours, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Colorectal Surgery Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Signoroni
- Unit of Hereditary Digestive Tract Tumours, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maura Massimino
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Marco Zecca
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Patrizia Dall'Igna
- Department of Women's and Children's Health, Pediatric Surgery Unit, Padova University Hospital, Padova, Italy
| | | | - Alessandro Inserra
- Department of Pediatric Surgery, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Stefano Chiaravalli
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Eleonora Basso
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Torino, Italy
| | - Calogero Virgone
- Division of Pediatric Surgery, Department of Pediatrics, Padova University Hospital, Padova, Italy
| | - Silvia Sorbara
- Hematology-Oncology Division, Department of Pediatrics, Padova University Hospital, Padova, Italy
| | - Maria Di Bartolomeo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo D'Angelo
- Pediatric Oncology Unit, G. Di Cristina Children's Hospital, Palermo, Italy
| | - Andrea Ferrari
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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8
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Saliba J, Cherrick I, Wali P. An Adolescent With Cough and Dyspepsia. Clin Pediatr (Phila) 2016; 55:776-8. [PMID: 26354781 DOI: 10.1177/0009922815606418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Joyce Saliba
- Golisano Children's Hospital, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Irene Cherrick
- Golisano Children's Hospital, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Prateek Wali
- Golisano Children's Hospital, SUNY Upstate Medical University, Syracuse, NY, USA
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9
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Primary gastric tumors in infants and children: 15 cases of 20-year report. J Cancer Res Clin Oncol 2016; 142:1061-7. [DOI: 10.1007/s00432-015-2103-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 12/18/2015] [Indexed: 01/08/2023]
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10
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Takeyama E, Tanaka M, Fujishiro J, Kitagawa N, Iwanaka T, Tanaka Y. A case of alpha-fetoprotein-producing gastric cancer in a child presenting with rupture of multiple liver metastases. Pediatr Surg Int 2015; 31:885-8. [PMID: 26081312 DOI: 10.1007/s00383-015-3724-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2015] [Indexed: 11/24/2022]
Abstract
We report a 14-year-old boy with alpha-fetoprotein-producing gastric cancer (AFPGC) who was found with ruptured metastatic tumor in the liver. AFPGC is exceedingly rare in pediatric age. It often shows metastases to the liver and should be included in differential diagnoses of liver tumors with increased serum AFP.
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Affiliation(s)
- Eriko Takeyama
- Department of Pathology, Kanagawa Children's Medical Center, Mutsukawa, 2-138-4, Minami-ku, Yokohama, Kanagawa, 232-8555, Japan,
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11
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Lin CH, Lin WC, Lai IH, Wu SF, Wu KH, Chen AC. Pediatric gastric cancer presenting with massive ascites. World J Gastroenterol 2015; 21:3409-3413. [PMID: 25805952 PMCID: PMC4363775 DOI: 10.3748/wjg.v21.i11.3409] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 10/23/2014] [Accepted: 11/11/2014] [Indexed: 02/06/2023] Open
Abstract
Gastric adenocarcinoma is quite rare in children and as a result very little experience has been reported on with regards to clinical presentation, treatment and outcome. We describe the case of a 16-year-old boy presenting with abdominal fullness and poor appetite for 7 d. Sonography showed massive ascites and computed tomography imaging revealed the presence of gastric mucosa thickness with omentum caking. The diagnosis of gastric adenocarcinoma was biopsy-proven endoscopically. Despite gastric adenocarcinoma being quite rare in the pediatric patient population, we should not overlook the possibility of gastric adenocarcinoma when a child presents with distended abdomen and massive ascites.
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12
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Abstract
Abdominal pain is a frequent complaint in the pediatric emergency department. A 13-year-old boy presented with complaints of abdominal pain, hematemesis, headache, and leg pain. Further investigation revealed an advanced-stage gastric adenocarcinoma with multiple thromboembolism including the greater saphenous vein and nonbacterial thrombotic endocarditis. This case points out the challenges of diagnosing this rare condition and treating the primary tumor and thromboembolism in the setting of both hypercoagulable state and gastrointestinal bleeding.
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13
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Gastric adenocarcinoma presenting with gastric outlet obstruction in a child. Case Rep Gastrointest Med 2014; 2014:527471. [PMID: 24707411 PMCID: PMC3965945 DOI: 10.1155/2014/527471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 11/17/2013] [Indexed: 11/28/2022] Open
Abstract
Gastric carcinoma is extremely rare in children representing only 0.05% of all gastrointestinal malignancies. Here, we report the first pediatric case of gastric cancer presenting with gastric outlet obstruction. Upper endoscopy revealed a markedly thickened antral mucosa occluding the pylorus and a clean base ulcer 1.5 cm × 2 cm at the lesser curvature of the stomach. The narrowed antrum and pylorus underwent balloon dilation, and biopsy from the antrum showed evidence of Helicobacter pylori gastritis. The biopsy taken from the edge of the gastric ulcer demonstrated signet-ring-cell type infiltrate consistent with gastric adenocarcinoma. At laparotomy, there were metastases to the liver, head of pancreas, and mesenteric lymph nodes. Therefore, the gastric carcinoma was deemed unresectable. The patient died few months after initiation of chemotherapy due to advanced malignancy. In conclusion, this case report underscores the possibility of gastric adenocarcinoma occurring in children and presenting with gastric outlet obstruction.
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14
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Schneider C, Simon T, Hero B, Uphoff US, Drebber U, Alakus H, Holinski-Feder E, Berthold F, Dietlein M, Schmidt MC. [18F]Fluorodeoxyglucose positron emission tomography/computed tomography-positive gastric adenocarcinoma in a 12-year-old girl with Peutz-Jeghers syndrome. J Clin Oncol 2012; 30:e140-3. [PMID: 22493416 DOI: 10.1200/jco.2011.39.7422] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Christina Schneider
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany.
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15
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Subbiah V, Varadhachary G, Herzog CE, Huh WW. Gastric adenocarcinoma in children and adolescents. Pediatr Blood Cancer 2011; 57:524-7. [PMID: 21744476 PMCID: PMC3137240 DOI: 10.1002/pbc.23051] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 01/03/2011] [Indexed: 12/14/2022]
Abstract
Gastric adenocarcinoma (GAC) is an extremely rare cancer in children with very limited information on the clinical presentation and outcome. We report five pediatric patients with GAC-treated between 1990 and 2008 at our institution. Median age at diagnosis was 17 years (range: 8-17). Our case series suggests that pediatric GAC patients present with diffuse metastatic disease (four patients) and with patterns of spread similar to adult GAC. Initial chemotherapy was mainly platinum-based. Median time to progression was 4 months. The only long-term survivor was a patient with localized disease who had complete surgical removal of primary tumor.
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Affiliation(s)
- Vivek Subbiah
- The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
| | - Gauri Varadhachary
- Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Cynthia E. Herzog
- Division of Pediatrics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Winston W. Huh
- Division of Pediatrics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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16
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Raphael MF, Kluijt I, Koot BG, Smets AMJB, Tilanus MEC, Bras J, van de Wetering MD. Gastric adenocarcinoma in a 13-year-old boy: a diagnosis not often seen in this age group. Pediatr Hematol Oncol 2011; 28:71-7. [PMID: 21083354 DOI: 10.3109/08880018.2010.520820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Gastric adenocarcinoma is not uncommon in the adult population, but in the pediatric population it is an extremely rare entity. A 13-year-old boy was referred to a pediatric oncology unit for evaluation of a tumor in the upper abdomen. Further investigation revealed an advanced stage gastric carcinoma with metastases suggestive for a hereditary cause. Awareness for uncommon diagnoses is a key issue in regard of accurate treatment and overall prognosis.
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Affiliation(s)
- M F Raphael
- Department of Pediatric Hematology and Oncology, University Medical Center, Utrecht, The Netherlands.
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17
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Pediatric Intestinal Foregut and Small Bowel Solid Tumors: A Review of 105 Cases. J Surg Res 2009; 156:95-102. [DOI: 10.1016/j.jss.2009.03.054] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Revised: 02/22/2009] [Accepted: 03/22/2009] [Indexed: 12/30/2022]
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18
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Curtis JL, Burns RC, Wang L, Mahour GH, Ford HR. Primary gastric tumors of infancy and childhood: 54-year experience at a single institution. J Pediatr Surg 2008; 43:1487-93. [PMID: 18675640 DOI: 10.1016/j.jpedsurg.2007.11.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Revised: 11/12/2007] [Accepted: 11/12/2007] [Indexed: 02/01/2023]
Abstract
BACKGROUND/PURPOSE Primary gastric tumors are rare in infancy and childhood. Because of the infrequent occurrence of these tumors, the clinician may be unfamiliar with optimal management strategies. We review our experience over the past 54 years and the current literature. METHODS During the period extending from 1952 to 2006, 21 infants and children with primary gastric tumors were treated at Children's Hospital Los Angeles. The series includes 8 cases previously reported and 13 additional cases seen since the initial report. Follow-up information is included. RESULTS There were 12 males and 9 females, aged 12 days to 18 years, who were diagnosed with gastric tumors. The patients presented primarily with weight loss, vomiting, or an abdominal mass. Morphological analysis revealed gastric stromal tumors (n = 6), teratomas (n = 4), lymphomas (n = 4), adenocarcinomas (n = 2), inflammatory myofibroblastic tumors (n = 2), embryonal rhabdomyosarcoma (n = 1), and hamartomas (n = 3). There were 16 patients still alive (mean follow-up, 22.3 months), whereas 6 died from active disease despite multimodal treatment. The deaths occurred in patients with stromal tumors, adenocarcinomas, lymphomas, and rhabdomyosarcoma. CONCLUSIONS Gastric tumors in children are rare. A high index of suspicion is needed to diagnose these tumors. Most malignant tumors present at an advanced stage and carry a substantial rate of mortality. They should be completely resected whenever feasible. In the case of some malignancies, chemotherapy may play a major role. Metastatic evaluation should be performed in all patients with malignant gastric tumors.
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Affiliation(s)
- Jennifer L Curtis
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
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19
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Abstract
Tumors of the pediatric gastrointestinal tract are extremely rare. Their infrequent presentation at treatment centers has not allowed for the development of standardized treatment protocols and prospective review. The most prevalent gastrointestinal neoplasms and malignancies are described, including gastrointestinal lymphoma, colorectal carcinoma, carcinoid tumors, gastrointestinal stromal tumors, leiomyomas, juvenile polyps, inflammatory pseudotumors, gastric tumors, and Peutz-Jeghers polyposis syndrome. Current recommendations for the medical and surgical management of these tumors are reviewed and summarized for this vast group of gastrointestinal neoplasms in children.
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Affiliation(s)
- Alan P Ladd
- Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
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