An unusual cause of large bowel obstruction: are we aware of this?

Abstract

Primary lymphomas of the colon account for 0.5% of all primary colon malignancies. Burkitt´s lymphoma is a B-cell lymphoma with aggressive clinical behavior. Herein, we describe a case of a male patient who presented with signs of large bowel obstruction, underwent surgery and found to suffer from Burkitt´s lymphoma of the ileocecal region. The histopathological examination was indicative for Burkitt´s lymphoma. To the best of our insight this is one of the few reported cases of such type of lymphoma in an adult patient presenting with bowel obstruction. Burkitt´s lymphoma is a rare malignancy in adults affecting gastrointestinal tract. It has a high proliferation potential and can rapidly progress to advanced disease. Early diagnosis is necessary to prevent complications and improve overall prognosis.

Non‐surgical management of small bowel obstruction secondary to Burkitt's lymphoma

“…BL is noted to cause intussusception with consequent SBO in children, with surgical resection the recommended management 4,5 . Many case reports describe SBO secondary to BL in adults managed by surgical resection and adjuvant chemotherapy with diagnosis only confirmed post‐operatively 6–9 …”

“…However, there should be an emphasis on limited surgery in BL 5,8 as it is highly responsive to intensive chemotherapy 1,5 and surgery should only be reserved for diagnostic biopsies or the management of an acute abdomen 4 . Only one other case report mirrors our case: Mizutani et al 10 .…”

“…4,5 Many case reports describe SBO secondary to BL in adults managed by surgical resection and adjuvant chemotherapy with diagnosis only confirmed post-operatively. [6][7][8][9] However, there should be an emphasis on limited surgery in BL 5,8 as it is highly responsive to intensive chemotherapy 1,5 and surgery should only be reserved for diagnostic biopsies or the management of an acute abdomen. 4 Only one other case report mirrors our case: Mizutani et al 10 described a 38-year-old man with small intestine BL who presented with SBO and achieved resolution of both obstruction and disease remission through chemotherapy alone.…”