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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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Sobh MJ, Al Jayyousi OA, Mahasna A, Sobh RJ. Pediatric Gastric Adenocarcinoma Presenting As Hip Pain. Cureus 2023; 15:e34651. [PMID: 36895530 PMCID: PMC9991019 DOI: 10.7759/cureus.34651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2023] [Indexed: 02/09/2023] Open
Abstract
The third most lethal cancer in the world is gastric adenocarcinoma, which is uncommon in children. Patients with gastric adenocarcinoma typically experience vomiting, abdominal pain, anemia, and weight loss. We present a case of a 14.5-year-old male with gastric adenocarcinoma that manifested as left hip pain, epigastric pain, dysphagia, weight loss, and melena. Physical exam revealed cachexia, jaundice, a palpable epigastric mass, palpable liver edge, and left hip tenderness. Laboratory tests showed microcytic anemia, increase in carcinoembryonic antigen (CEA), and abnormal liver function test. Endoscopy revealed a cardial mass extending to the esophagus involving the gastroesophageal junction (GEJ). The gastric mass biopsy was consistent with invasive, moderately-differentiated gastric adenocarcinoma, which confirmed the diagnosis of gastric adenocarcinoma. Furthermore, a bone isotope scan revealed mildly hypervascular active bone pathology within the left proximal femur implying possible metastasis. Computed tomography scans and barium swallow were also helpful in supporting the diagnosis. Our case report emphasizes that gastric adenocarcinoma should be encompassed in the differential diagnosis of pediatric patients with hip pain.
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Affiliation(s)
- Mohammed J Sobh
- General Practice, King Abdullah University Hospital/Jordan University of Science and Technology, Ar Ramtha, JOR
| | - Obada A Al Jayyousi
- General Practice, King Abdullah University Hospital/Jordan University of Science and Technology, Ar Ramtha, JOR
| | - Ahmad Mahasna
- Surgical Oncology, Jordanian Royal Medical Services, Amman, JOR
| | - Rawan J Sobh
- Pediatrics, Mubarak Al-Kabeer Hospital, Jabriya, KWT
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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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Limantoro I, Lee AF, Rosenbaum DG. Spectrum of bowel wall thickening on ultrasound with pathological correlation in children. Pediatr Radiol 2022; 52:1786-1798. [PMID: 35513727 PMCID: PMC9072154 DOI: 10.1007/s00247-022-05376-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/04/2022] [Accepted: 04/01/2022] [Indexed: 11/30/2022]
Abstract
Applications for bowel US in children have been well described; however, less focus has been placed on patterns of bowel wall architectural change in specific disease states. This pictorial essay reviews normal bowel wall architecture and covers a variety of inflammatory, infectious, vascular and neoplastic disorders outside the neonatal period as seen on US, with illustrative pathological correlation. A thorough understanding of normal and abnormal bowel wall architecture can enrich sonographic interpretation and provide a valuable adjunct to appropriate clinical investigation.
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Affiliation(s)
- Ione Limantoro
- Department of Radiology, British Columbia Children’s Hospital, University of British Columbia, 4500 Oak St., Vancouver, BC V6H 3N1 Canada
| | - Anna F. Lee
- Department of Pathology and Laboratory Medicine, British Columbia Children’s Hospital, University of British Columbia, Vancouver, BC Canada
| | - Daniel G. Rosenbaum
- Department of Radiology, British Columbia Children’s Hospital, University of British Columbia, 4500 Oak St., Vancouver, BC V6H 3N1 Canada
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Cortés Hernández M, García Hidalgo L, Escobosa Sánchez O, Acha García T. [Pseudoachalasia as first manifestation of adenocarcinoma]. An Pediatr (Barc) 2021; 96:S1695-4033(21)00179-X. [PMID: 34332881 DOI: 10.1016/j.anpedi.2021.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/06/2021] [Accepted: 04/21/2021] [Indexed: 02/07/2023] Open
Affiliation(s)
- Marta Cortés Hernández
- Unidad de Oncología Pediátrica, Hospital Materno Infantil de Málaga, Hospital Regional Universitario de Málaga, Málaga, España.
| | - Laura García Hidalgo
- Unidad de Oncología Pediátrica, Hospital Materno Infantil de Málaga, Hospital Regional Universitario de Málaga, Málaga, España
| | - Olga Escobosa Sánchez
- Unidad de Oncología Pediátrica, Hospital Materno Infantil de Málaga, Hospital Regional Universitario de Málaga, Málaga, España
| | - Tomás Acha García
- Unidad de Oncología Pediátrica, Hospital Materno Infantil de Málaga, Hospital Regional Universitario de Málaga, Málaga, España
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SK P, Kandasamy D, Jana M, Sharma R, Gupta AK. Pediatric Stomach and Duodenal Imaging. JOURNAL OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY 2021. [DOI: 10.1055/s-0041-1723926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
AbstractPediatric stomach and duodenum abnormalities constitute a unique spectrum of conditions unlike adults which are categorized broadly into congenital, inflammatory, neoplastic and miscellaneous conditions. The aim of this article is to describe the role of imaging modalities in gastric and duodenal pathology in children. Some of the entities are unique to this age group and their imaging findings are also highlighted.
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Affiliation(s)
- Pritviraj SK
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | | | - Manisha Jana
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Raju Sharma
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Arun Kumar Gupta
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
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The pediatric stomach - masses and mass-like pathology. Pediatr Radiol 2020; 50:1180-1190. [PMID: 32474774 DOI: 10.1007/s00247-020-04697-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/22/2020] [Accepted: 04/23/2020] [Indexed: 02/06/2023]
Abstract
Diagnostic imaging of pediatric gastric masses often provides a challenge for the practicing radiologist. Radiologists should be aware of this relatively unusual pathology, particularly in cross-sectional imaging findings. We will review pediatric gastric masses and mass-like lesions, focusing on neoplastic and inflammatory etiologies.
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Tessler RA, Dellinger M, Richards MK, Goldin AB, Beierle EA, Doski JJ, Goldfarb M, Langer M, Nuchtern JG, Raval MV, Vasudevan S, Gow KW. Pediatric gastric adenocarcinoma: A National Cancer Data Base review. J Pediatr Surg 2019; 54:1029-1034. [PMID: 30824240 DOI: 10.1016/j.jpedsurg.2019.01.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 01/27/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE We sought to compare the presentation, management, and outcomes in gastric adenocarcinoma cancer for pediatric and adult patients. METHODS Using the 2004 to 2014 National Cancer Database (NCDB), patients ≤21 years (pediatric) were retrospectively compared to >21 years (adult). Chi-squared tests were used to compare categorical variables, and Cox regression was used to estimate hazard ratios (HR) for survival differences. RESULTS Of the 129,024 gastric adenocarcinoma cases identified, 129 (0.10%) occurred in pediatric patients. Pediatric cases presented with more advanced disease, including poorly differentiated tumors (81% vs 65%, p = 0.006) and stage 4 disease (56% vs 41%, p = 0.002). Signet ring adenocarcinoma comprised 45% of cases in the pediatric group as compared to 20% of cases in the adults (P < 0.001). Similar proportions in both groups underwent surgery. However, near-total gastrectomy was more common in the pediatric group (16% vs 6%, p < 0.001). The proportions of patients with negative margins, nodal examination, and presence of positive nodes were similar. There was no overall survival difference between the two age groups (HR 0.92, 95% Confidence interval 0.73-1.15). CONCLUSION While gastric adenocarcinoma in pediatric patients present with a more advanced stage and poorly differentiated tumors compared to adults, survival appears to be comparable. TYPE OF STUDY Retrospective cohort study. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Robert A Tessler
- Seattle Children's Hospital, Division of General and Thoracic Surgery, Seattle, WA; University of Washington Harborview Injury Prevention and Research Center, Seattle, WA; University of Pittsburgh, Department of Surgery, Pittsburgh, PA
| | - Matthew Dellinger
- Seattle Children's Hospital, Division of General and Thoracic Surgery, Seattle, WA
| | - Morgan K Richards
- Seattle Children's Hospital, Division of General and Thoracic Surgery, Seattle, WA
| | - Adam B Goldin
- Seattle Children's Hospital, Division of General and Thoracic Surgery, Seattle, WA
| | | | - John J Doski
- UT Health Science Center San Antonio, San Antonio, TX
| | | | - Monica Langer
- Ann & Robert H. Lurie Children's Hospital of Chicago, Pediatric Surgery, Chicago, IL
| | - Jed G Nuchtern
- Texas Children's Hospital, Pediatric Surgery, Houston, TX
| | | | | | - Kenneth W Gow
- Seattle Children's Hospital, Division of General and Thoracic Surgery, Seattle, WA.
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Perezpeña-Diazconti M, Hinojosa Armendáriz V, Cortés Sauza J. [Gastric adenocarcinoma with signet-ring cell and neuroendocrine differentiation. A rare cancer in adolescents]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2016; 73:268-277. [PMID: 29421390 DOI: 10.1016/j.bmhimx.2016.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 06/22/2016] [Indexed: 11/26/2022] Open
Affiliation(s)
- Mario Perezpeña-Diazconti
- Departamento de Patología Clínica y Experimental, Hospital Infantil de México Federico Gómez, Ciudad de México, México.
| | | | - Jorge Cortés Sauza
- Departamento de Cirugía Oncológica, Hospital Infantil de México Federico Gómez, Ciudad de México, México
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