Surgical management of children with Burkitt's lymphoma involving the gastrointestinal tract
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In brief
In brief
This retrospective study of 87 pediatric patients examines surgical management of Burkitt's lymphoma with gastrointestinal involvement, where intussusception was the primary surgical indication in two-thirds of cases. Surgery proved essential for resolving complications and enabling timely chemotherapy initiation, with excellent outcomes including minimal recurrence and no mortality.
- Intussusception is the primary surgical indication in pediatric GI Burkitt's lymphoma (67% of cases), requiring enterectomy in most patients.
- The ileocecal region is the most common site of GI involvement in pediatric Burkitt's lymphoma (36% of cases).
- Surgery enables timely diagnosis and chemotherapy initiation with excellent outcomes: 2.4% recurrence, 4.8% reoperation, zero mortality.
- Abdominal pain (85%) and palpable mass (52%) are the predominant presenting symptoms in children with GI Burkitt's lymphoma.
- Open biopsy is appropriate for abdominal mass without obstruction, while resection is indicated for intussusception management.
Written by the GCMD Library team from the article.
Abstract
Purpose
To investigate the clinical characteristics and surgical management of children with Burkitt's lymphoma (BL) involving the gastrointestinal tract.
Methods
A retrospective analysis was conducted on 87 pediatric patients diagnosed with BL involving the gastrointestinal tract and treated surgically at Beijing Children's Hospital (2008–2022). All patients were histopathologically confirmed with BL and diagnosed with gastrointestinal involvement through imaging studies and surgery. Clinical data were reviewed and analyzed.
Results
Among 87 patients, 79 were male and 8 were female, with an average age of 6.8 ± 3.3 years. Predominant clinical manifestations included abdominal pain (74/87, 85.1%) and abdominal mass (45/87, 51.7%). The ileocecal region (31/87, 35.6%) was the most frequent involvement site. The presence of intussusception (58/87, 66.7%) was the main indication for surgery, of which 56 (56/58, 96.6%) underwent enterectomy and anastomosis. Twenty-two (22/87, 25.3%) patients underwent surgery for abdominal mass, with 15 (15/22, 68.2%) receiving an open biopsy. During the follow-up period, 2 patients (2/83, 2.4%) experienced recurrence, 4 patients (4/83, 4.8%) required reoperation, and no deaths were reported.
Conclusion
The main surgical indications for gastrointestinal BL are intussusception and abdominal mass. Surgery plays a crucial role in resolving intussusception, clarifying the diagnosis, and ultimately facilitating the timely initiation of chemotherapy without delay.