Gastric MALT lymphoma presented with primary perforation in an adolescent: a case report

Abstract

Background Primary lymphomas of the gastrointestinal tract are rare, accounting for only 1 to 4% of malignancies arising in the stomach, small intestine, or colon. The stomach is the most common extranodal site of lymphoma and gastric mucosa-associated lymphoid tissue (MALT) lymphoma accounts for 40% of primary gastric lymphoma. Gastric MALT lymphoma reaches its peak incidence between 50 to 60 years of age, therefore, it is rarely encountered in pediatric population. The presenting symptoms of gastric MALT lymphoma are usually nonspecific and primary perforation of gastric MALT lymphoma is uncommon. Case presentation A 12 year-old female presented with iron deficient anemia developed gastric perforation. Emergency laparoscopic repair of the perforation was performed and tissue pathology showed gastric MALT lymphoma infiltration. Helicobacter pylori eradication and radiotherapy were sequentially performed. Complete remission was achieved at two months after radiotherapy. To our best knowledge, she is the youngest patient with gastric MALT lymphoma reported in the literature. Conclusion Iron deficient anemia is a common presenting manifestation of malignancies in adulthood. In pediatric population, iron deficient anemia is usually caused by nutritional deficient or blood loss. In this case report, we present a teenaged female without previous gastric ulcer history who presented with a rare gastric tumor and an uncommon primary perforation. Even if there is an uncertainty about the exact diagnosis prior to the surgery, the strategy of stomach-preserving therapy by laparoscopy for primary perforation was successful and provided a good quality of life. Electronic supplementary material The online version of this article (10.1186/s12887-019-1431-9) contains supplementary material, which is available to authorized users.

Spontaneous perforation of primary gastric diffuse large B‐cell lymphoma

“…The present case fulfilled all the cited criteria, so it was considered to be a primary gastric lymphoma. It has a natural history of slow progression; most cases occur in male individuals of 50 years old or older, with primary gastric lymphoma being the most common in the sixth decade 2 …”

“…Gastrointestinal non‐Hodgkin lymphoma is the most common form of extra nodal lymphoma 1 . The complications associated with this lymphoma are perforation, bleeding, or upper gastrointestinal stricture 2 . Diffuse large B‐cell malignant lymphoma is the most frequent type of non‐Hodgkin gastric localization.…”

“… 1 The complications associated with this lymphoma are perforation, bleeding, or upper gastrointestinal stricture. 2 Diffuse large B‐cell malignant lymphoma is the most frequent type of non‐Hodgkin gastric localization. Gastric perforation in diffuse large B‐cell lymphoma (DLBCL) during chemotherapy is a well‐known event.…”

A dynamic predictive nomogram of long-term survival in primary gastric lymphoma: a retrospective study

“…PGL is the most common extranodal NHL and ranks as second most common gastric malignant neoplasm [1][2][3]. The PGL is a relatively rare cancer and easily misdiagnosed due to its unspeci c symptoms [15][16][17]. There are many treatment options include gastrectomy, radiotherapy, chemotherapy, immunotherapy, and observation, while gastrectomy remains controversial due to considerably favourable prognosis versus quality of life [18][19][20][21][22][23][24].…”

A dynamic predictive nomogram of long-term survival in primary gastric lymphoma: a retrospective study

“…PGL is the most common extranodal NHL and ranks as the second most common tumour of the stomach [ 1 – 3 ]. PGL is a relatively rare cancer and is easily misdiagnosed due to its non-specific symptoms [ 16 – 18 ]. There are many treatment options include gastrectomy, radiotherapy, chemotherapy, immunotherapy, and observation, while gastrectomy remains controversial due to a considerably favorable prognosis versus quality of life [ 19 – 25 ].…”