Primary gastric adenocarcinoma in a 2.5-year-old girl

Abstract

anemia (hemoglobin [Hb], 2.6 g/l; hematocrit [Htc], 7) of the child was treated. Routine laboratory test results were nonspecific. Serum tumor markers, such as carcinoembryonic antigen alpha-fetoprotein, antigen (CEA), and human chorionic gonadotropin (HCG) were negative. Her blood group was B rh (ϩ). She came from a family of six children living in a rural mountain area. The family history of the child was not informative. There was no history of childhood tumor or gastrointestinal malignancies in the family and close relatives. However, several gastrointestinal infections had frequently occurred in the family.At surgery, we found a large, irregularly circumferential solid mass, extending from the corpus to 1.5 cm below the pylorus, originating from the lesser curvature. There was a firm extension to the omentum and the abdominal wall. The stomach outside the mass invasion had a normal appearance. The liver and other intraperitoneal organs appeared free of gross disease. Complete resection of the mass and a subtotal gastrectomy (80%) was performed. A retrocolic gastrojejunostomy and omentectomy, removing all gross disease, completed the procedure. The resected specimen was a dark brown mass, 12 ϫ 7 ϫ 7cm in diameter, which had almost obliterated the gastric lumen. The intraluminal part of the mass had a soft, grayish, highly fragile nodular form in which gross mucous areas were remarkable. Lymph nodes in the area appeared normal, and representative biopsies were free of tumor.Microscopically, tumoral infiltration through the gastric wall was seen. We observed glandular structures presenting atypical epithelial cells, atypical mitosis, abundant eosinophylic cytoplasm, and highly hyperchromatic cells, and some large extracellular mucin-containing areas among these structures. Immunochemical staining of the specimen for epithelial membrane antigen (EMA) was positive, and staining for vimentin, smooth muscle actin, and alpha-fetoprotein was negative. The histological diagnosis, according Abstract Primary gastric adenocarcinoma is extremely rare in children. Here, we report an additional case of primary adenocarcinoma, located at the lesser curvature in a girl at the age of 2.5 years. She had no family history and no apparent underlying cause for the tumor. She died 4 months after admission despite complete resection of the mass and chemotherapy.

Pediatric Intestinal Foregut and Small Bowel Solid Tumors: A Review of 105 Cases

“…The majority of our patients were greater than 10 y of age, with 15-to 19-y-olds comprising the largest group. This is agreement with studies that describe the median age of presentation to be approximately 15 y of age [11,12].…”

Primary gastric tumors of infancy and childhood: 54-year experience at a single institution

“…Reports of childhood gastric carcinomas are limited to case reports [35][36][37]. Larger cohorts include younger adults (age b40) [38].…”

Treatment issues in pediatric gastric adenocarcinoma

“…4,5 Children suffering from gastric cancer often present with abdominal pain, distension, anorexia, emesis/hematemesis, melena, hematochezia, and/or an abdominal mass. [6][7][8][9] Unfortunately, early diagnosis is extremely rare, and the onset of symptoms is frequently indicative of advanced disease and a poor prognosis. 10 After studying 127 patients younger than age 35 years, Windham et al 11 concluded that early diagnosis conferred no survival advantage.…”