Gastric adenocarcinoma in children and adolescents

Subbiah, Vivek; Varadhachary, Gauri R.; Herzog, Cynthia E.; Huh, Winston W.

doi:10.1002/pbc.23051

Cited by 41 publications

(56 citation statements)

References 23 publications

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“…Gastric adenocarcinoma (GAC) is extremely rare in children, accounting for about 0.5% of all malignancies of the gastrointestinal tract. 13,14 It usually affects patients between 50 and 70 years, and is uncommon before the age of 40. The etiology of GAC is multifactorial, and risk factors include alcohol consumption, smoking, high-sodium diet, few vegetables, foods with nitrous components, and infections such as Epstein-Barr and H. pylori.…”

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confidence: 99%

“…As a result, gastric adenocarcinomas in pediatric patients have more advanced stage at diagnosis, presenting worse prognosis compared to adults. 13,14 Treatment of GAC in children is usually based on methods used in adults, due to the rarity of this disease in pediatric populations, and therefore there is no standard treatment model. 13,15 references…”

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confidence: 99%

“…GAC appears in children sporadically as a consequence of inherited syndromes or after treatment of gastric lymphomas. 13,14 Differential diagnoses for pediatric gastric tumors include stromal tumors, hemangioma, lymphoma, squamous cell carcinoma, carcinoid tumors, fibroids, polyps from hereditary syndromes, leiomyosarcoma, and lipoma. 13,14 Symptoms vary according to the site of involvement and the extent of the tumor.…”

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confidence: 99%

“…13,14 Differential diagnoses for pediatric gastric tumors include stromal tumors, hemangioma, lymphoma, squamous cell carcinoma, carcinoid tumors, fibroids, polyps from hereditary syndromes, leiomyosarcoma, and lipoma. 13,14 Symptoms vary according to the site of involvement and the extent of the tumor. Tumors located in the cardia lead to dysphagic symptoms, while tumors located distal to the cardia gastric produce nonspecific symptoms such as abdominal pain, loss of appetite, weight loss, vomiting, anorexia, fatigue, bloating, hematemesis, and melena.…”

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confidence: 99%

“…Tumors located in the cardia lead to dysphagic symptoms, while tumors located distal to the cardia gastric produce nonspecific symptoms such as abdominal pain, loss of appetite, weight loss, vomiting, anorexia, fatigue, bloating, hematemesis, and melena. [13][14][15] Barium-contrast radiography can be used for initial investigation as an alternative in locations without access to more complex tests. The main findings are polyps, ulcers, discontinuation and thickening of the folds, areas of barium filling defect, loss of gastric distension, and stenoses.…”

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confidence: 99%

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Ménétrier’s disease associated with gastric adenocarcinoma in a child – imaging aspect

Silva

Rigo²,

Batista³

et al. 2016

Rev. Assoc. Med. Bras.

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confidence: 99%

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confidence: 99%

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confidence: 99%

See 3 more Smart Citations

Ménétrier’s disease associated with gastric adenocarcinoma in a child – imaging aspect

Silva

Rigo²,

Batista³

et al. 2016

Rev. Assoc. Med. Bras.

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Treatment of a pediatric patient with MET‐amplified signet ring cell adenocarcinoma of the stomach with crizotinib

Sabree

Berg

Sato

2018

Pediatric Blood & Cancer

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The patient received chemotherapy using epirubicin, oxaliplatin, and fluorouracil for 6 months, but developed a new hepatic lesion at the end of chemotherapy ( Figure 1F). Laparoscopic biopsy of the hepatic lesion revealed active metastatic cancer and residual cancer cells at the antrum. Palliative therapy was subsequently initiated using crizotinib, a dual ALK/MET inhibitor. Three months later, patient achieved PET-negative remission ( Figure 1G) lasting for 8 months before presenting with recurrent headaches and vision loss. Imaging studies revealed significant disease progression with mediastinal and retroperitoneal hypermetabolic lymphadenopathy, multiple extensive osseous metastases including the left pelvic area, a high degree of PET avidity in the right humerus area, left lower pulmonary nodules, a right common iliac lymph node, and a small hypermetabolic infiltrate in the right middle lobe of the brain ( Figure 1H). Despite the initiation of the third-line chemotherapy with paclitaxel and ramucirumab, patient developed multisystem organ failure as a result of widely metastatic adenocarcinoma and succumbed to his disease, 18 months after initial diagnosis. DISCUSSIONGastrointestinal malignancies are a rare occurrence in the pediatric population and show a poorer overall survival when compared to the adult population. 1-3 A study conducted in 2015 by Poles et al. demonstrated that as compared to adults, pediatric patients are 8-17 times more likely to have higher proportions of signet ring cell histology. This aggressive form of tumor biology is a significant predicator of mortality and is increasing in prevalence, as reported by Henson et al. 4,5 Our literature review of pediatric SRCA cases in the GI tract revealed 30 cases between 1985 and 2016, many of which underwent aggressive treatment regimens (Supplementary Table S1). The prognosis for pediatric SRCA remains poor with a median survival time of 9 months (ranges from 19 days to 18 months, 20 available outcomes), compared to a median survival time of 9-11 months in the adult population for all esophagogastric cancers. 6 The outcome of SRCA was recently reported by Pernot et al. to be controversial. 7 Our patient achieved 8 months of extended quality of life after crizotinib was selected for palliative treatment, with an overall survival of 18 months. CONCLUSIONSOur report represents a novel case of utilizing genetic testing in a pediatric patient with SRCA to influence treatment and improve outcome for a patient with a poor prognosis.

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Polyps and Tumors of the Gastrointestinal Tract in Childhood

Pawel

2024

Pathology of Pediatric Gastrointestinal and Liver Disease

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Gastric adenocarcinoma in children and adolescents

Cited by 41 publications

References 23 publications

Ménétrier’s disease associated with gastric adenocarcinoma in a child – imaging aspect

Ménétrier’s disease associated with gastric adenocarcinoma in a child – imaging aspect

Treatment of a pediatric patient with MET‐amplified signet ring cell adenocarcinoma of the stomach with crizotinib

Polyps and Tumors of the Gastrointestinal Tract in Childhood

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