Clinical analysis of primary gastric tumors in 15 children

Abstract

Objective To summarize the clinical characteristics, diagnosis and treatment of primary gastric tumors in children. Methods In combination with a related literature review, the clinical data of 15 children with pathologically confirmed primary gastric tumors from March 1993 to March 2014 were analyzed retrospectively. And their postoperative conditions were followed up. Results There were 9 boys and 6 girls with an average age at diagnosis of (6.5±4.3) years. The most common sites were gastric body and gastric antrum. And the average maximum diameter of mass was (6.3±2.6) cm. The major onset symptoms were abdominal pain, melena, fever of undetermined origin and pallor. Alone or in combination with ultrasound, computed tomography (CT) and upper gastrointestinal barium meal and gastroscopy, huge mass in abdomen or stomach or polypoid space-occupying lesions were visualized. The procedures were simple tumor resection (n=3), gastric wall resection plus gastric repair (n=7), subtotal gastric resection with digestive tract reconstruction (n=4) and palliative resection of gastric carcinoma (n=1). And malignant gastric tumors (n=3) and gatric stromal tumor (n=1) received postoperative chemotherapy. During a follow-up period of 3-92 months, 4 cases were lost and 1 case died of gastric adenocarcinoma. Two cases of gastric adenomas were recurrent and others survived without recurrence or progression. Conclusions Primary gastric tumors are rare in children. However, the pathological types are diverse. Most of them originate from mesenchymal tissue. Early diagnosis is difficult due to atypical symptoms. Benign and borderline gastric tumors are more common than primary gastric tumor in children. Surgery is a major treatment with a good prognosis. But malignant and borderline tumors have a great tendency of recurrence and progression so that close follow-ups are necessary. For gastric malignant tumor, the principle and standard regimens of chemotherapy should be further explored. Key words: Child; Stomach neoplasms; Diagnosis; Clinical protocols