[An abdominal Burkitt's lymphoma in acute phase. Case report].
Burkitt's lymphoma is a highly malignant, aggressive and rapidly growing B-cell neoplasm, which has low long-term survival rates. Abdomen is the most frequent onset site of nonendemic Burkitt's lymphoma. The rapidity of volumetric doubling of this neoplasm frequently justifies an abdominal acute presentation, that may mime other less rare diseases. Symptoms are often misleading and make diagnosis difficult. The aim of this work is to report a case of a 13-year-old boy affected by terminal ileum Burkitt's lymphoma with hepatic metastasis, which initially was mistaken for acute appendicitis complicated by hepatic abscesses and, following a second surgical operation, for terminal-ileum inflammatory bowel disease. The rapidity of growth of this neoplasm justifies the finding, during the second surgical operation, of a mass that was not clinically manifested during first operation, carried out only a week ago. Clinical signs and instrumental investigations were not diagnostic, as well as the literature reports. The role of surgery remains controversial, and is usually limited to collection of specimens for histological diagnosis or to management of acute complications, as in our case report. Mostly treatment protocols are based on chemotherapy, because of the high sensibility of this neoplasm.
Cossaro
M
M
Clinica Chirurgica, Policlinico Universitario, Udine, Italy. banestino@libero.it
Noce
L
L
Bonutti
A
A
Pecile
P
P
Di Loreto
C
C
Saro
F
F
Intini
S
S
Terrosu
G
G
D000208:Acute Disease; D000293:Adolescent; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001064:Appendicitis / Q000175:diagnosis*; D002051:Burkitt Lymphoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D003561:Cytarabine / Q000008:administration & dosage / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use; D011860:Radiography, Abdominal; D012074:Remission Induction; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine; D008727:Methotrexate