Burkitt lymphoma as a cause of recurrent abdominal pain and ileocolic intussusception in a 6-yar-old boy

Abstract

Burkitt lymphoma is a highly aggressive form of Non – Hodgkin lymphoma that responds favorably to early treatment. The disease has many forms of clinical presentations. It is diagnosed in children usually as an abdominal mass. The tumor causes either indirect symptoms, due to pressure phenomena or direct involvement of the bowel lumen leading to either intestinal obstruction or intussusception. We report a case of a 6-year-old immunocompetent Caucasian boy who experienced a recurrent abdominal pain (RAP) for the last four months. After symptoms of bowel obstruction, we operated on him at the Department of Pediatric Surgery and ileocolic intussusception was found. We performed right colectomy. Sectioning the invaginate we found a tumor, spreading from the terminal ileum and involving the ileocecal valve. The tumor was immunohistochemically verified as Burkitt lymphoma. CT of neck, mediastinum and abdomen showed polyadenopathy. The child was referred to the pediatric hematology center for chemotherapy. Conclusion: Burkitt lymphoma rarely causes recurrent abdominal pain in children. The common presentation are bowel obstruction and intussusception. The possibility of lymphoma should be considered in case of intussusception in older children. Therapeutic approach includes combination of surgery and chemotherapy.