Annals of Surgical Oncology

, Volume 1, Issue 4, pp 283–289 | Cite as

Gastrointestinal tumors in children: An analysis of 39 cases

  • Michael A. Skinner
  • Donald A. Plumley
  • Jay L. Grosfeld
  • Frederick J. Rescorla
  • Karen W. West
  • L. R. Scherer


Background: Gastrointestinal tumors are relatively uncommon in infants and children, and the histologic diagnoses differ from those seen in an adult practice. Furthermore, the clinical presentation of such tumors is quite variable.

Methods: We reviewed the records of 39 pediatric patients who had been treated for tumors of the alimentary tract at our hospital over the past 20 years. The symptoms, physical findings, treatments, and outcomes are tabulated and discussed.

Results: Non-Hodgkin's lymphoma was the predominant diagnosis. It was found in 22 children, and the survival rate was 60%. Other malignant tumors found in this pediatric series included colorectal carcinoma in four patients and gastric leiomyosarcoma in one. The outcomes of these patients were poor; four of the children have died, and one girl remains alive with extensive disease. Benign lesions included neurogenic tumors (n=5), inflammatory pseudotumors (n=3), hemangiomas (n=2), teratoma and carcinoid (n=1 each). These tumors were ultimately cured, with one exception, after surgical resection.

Conclusions: Gastrointestinal tumors in children cover a broad spectrum of benign and malignant varieties and stem from conditions that differ significantly from those observed in adults. While treatment varies according to diagnosis, most patients respond best to complete resection of the primary tumor.

Key Words

Pediatric oncology Gastrointestinal tumors Abdominal lymphoma Inflammatory pseudotumor 


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  1. 1.
    Link MP. Non-Hodgkin's lymphoma in children.Pediatr Clin North Am 1985;32:699–720.PubMedGoogle Scholar
  2. 2.
    Franssila KO, Heiskala MK, Rapola J. Non-Hodgkin's lymphomas in childhood: a clinic-pathologic and epidemiologic study in Finland.Cancer 1987;59:1837–46.CrossRefPubMedGoogle Scholar
  3. 3.
    Magrath IT. Malignant non-Hodgkin's lymphomas. In: Pizzo A, Poplack G, eds.Pediatric oncology. Philadelphia: J. B. Lippincott, 1989:415–55.Google Scholar
  4. 4.
    Lenoir G, Philip T, Sohier R. Burkitt-type lymphoma: EBV association and cytogenetic markers in cases from various geographical locations. In: Magrath IT, O'Conor G, Ramot B, eds.Pathogenesis of leukemias and lymphomas: environmental influences. New York: Raven Press, Ltd., 1984:283–95.Google Scholar
  5. 5.
    Gatti RA, Good RA. Occurrence of malignancy in immunodeficiency diseases: a literature review.Cancer 1971;28:89–98.CrossRefPubMedGoogle Scholar
  6. 6.
    Kersey JH, Spector BD, Good RA. Cancer in children with primary immunodeficiency diseases.J Pediatr 1974;84:263–4.CrossRefPubMedGoogle Scholar
  7. 7.
    Murphy SB. Management of childhood non-Hodgkin's lymphoma.Cancer Treat Rep 1977;61:1161–73.PubMedGoogle Scholar
  8. 8.
    Takahashi H, Hansmann ML. Primary gastrointestinal lymphoma in childhood (up to 18 years of age).J Cancer Res Clin Oncol 1990;116:190–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Magrath IT. Malignant non-Hodgkin's lymphomas in children.Hemat/Oncol Clin North Am 1987;1:577–602.Google Scholar
  10. 10.
    Magrath I, Lee YJ, Anderson T, et al. Prognostic factors in Burkitt's lymphoma.Cancer 1980;45:1507–15.CrossRefPubMedGoogle Scholar
  11. 11.
    Azab MB, Henry-Amar M, Rougier P, et al. Prognostic factors in primary gastrointestinal non-Hodgkin's lymphoma.Cancer 1989;64:1208–17.CrossRefPubMedGoogle Scholar
  12. 12.
    Murphy SB, Fairclough DL, Hutchison RE, Berard CW. Non-Hodgkin's lymphomas of childhood: an analysis of the histology, staging and response to treatment of 338 cases at a single institution.J Clin Oncol 1989;7:186–93.PubMedGoogle Scholar
  13. 13.
    Cohen LF, Balow JE, Magrath IT, Poplack DG, Ziegler JL. Acute tumor lysis syndrome: a review of 37 patients with Burkitt's lymphoma.Am J Med 1980;68:486–91.CrossRefPubMedGoogle Scholar
  14. 14.
    Magrath IT, Lwanga S, Carswell W, Harrison N. Surgical reduction of tumour bulk in management of abdominal Burkitt's lymphoma.Br Med J 1974;2:308–12.CrossRefPubMedGoogle Scholar
  15. 15.
    Talamonti MS, Dawes LG, Joehl RJ, Nahrwold DL. Gastrointestinal lymphoma.Arch Surg 1990;125:972–7.PubMedGoogle Scholar
  16. 16.
    Fleming ID, Turk PS, Murphy SB, Crist WM, Santana VM, Rao BN. Surgical implications of primary gastrointestinal lymphoma of childhood.Arch Surg 1990;125:252–6.PubMedGoogle Scholar
  17. 17.
    LaQuaglia MP, Stolar CJH, Krailo M, Exelby P, Siegel S, Meadows A. The role of surgery in abdominal non-Hodgkin's lymphoma: experience from the Children's Cancer Study Group.J Pediatr Surg 1992;27:230–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Shamberger RC, Weinstein HJ. The role of surgery in abdominal Burkitt's lymphoma.J Pediatr Surg 1992;27:236–40.CrossRefPubMedGoogle Scholar
  19. 19.
    Stovroff MC, Coran AG, Hutchinson RJ. The role of surgery in American Burkitt's lymphoma in children.J Pediatr Surg 1991;25:1235–8.CrossRefGoogle Scholar
  20. 20.
    Magrath IT, Edwards BK, Spiegel R, et al. An effective therapy for both undifferentiated (including Burkitt's) lymphomas and lymphoblastic lymphomas in children and young adults.Blood 1984;63:1102–11.PubMedGoogle Scholar
  21. 21.
    Murphy SB, Bowman WP, Abromowitch M, et al. Results of treatment of advanced-stage Burkitt's lymphoma and B cell (SIg+) acute lymphoblastic leukemia with high-dose fractionated cyclophosphamide and coordinated high-dose methotrexate and cytarabine.J Clin Oncol 1986;4:1732–9.PubMedGoogle Scholar
  22. 22.
    Anderson JR, Wilson JF, Jenkin DT, et al. Childhood non-Hodgkin's lymphoma.N Engl J Med 1983;308:559–65.CrossRefPubMedGoogle Scholar
  23. 23.
    Janus C, Edwards BK, Sariban E, Magrath IT. Surgical resection and limited chemotherapy for abdominal undifferentiated lymphomas.Cancer Treat Rep 1984;68:599–605.PubMedGoogle Scholar
  24. 24.
    Lewis CT, Riley WE, Georgeson E, Warren JH. Carcinoma of the colon and rectum in patients less than 20 years of age.South Med J 1990;83:383–5.CrossRefPubMedGoogle Scholar
  25. 25.
    Rao BN, Pratt CB, Fleming ID, Dilawari RA, Green AA, Austin BA. Colon carcinoma in children and adolescents.Cancer 1985;55:1322–6.CrossRefPubMedGoogle Scholar
  26. 26.
    Rose RH, Axelrod DM, Aldea PA, Beck AR. Colorectal carcinoma in the young.Clin Pediatr 1988;27:105–8.CrossRefGoogle Scholar
  27. 27.
    Steinberg JB, Tuggle LDW, Postier RG. Adenocarcinoma of the colon in adolescents.Am J Surg 1988;156:460–2.CrossRefPubMedGoogle Scholar
  28. 28.
    Angel CA, Pratt DB, Rao BN, et al. Carcinoembryonic antigen and carbohydrate 19-9 antigen as markers for colorectal carcinoma in children and adolescents.Cancer 1992;69:1487–90.CrossRefPubMedGoogle Scholar
  29. 29.
    Scully RE, Mark EJ, McNeely BU. Case records of the Massachusetts General Hospital.N Engl J Med 1984;310:839–45.CrossRefGoogle Scholar
  30. 30.
    Chen HP, Lee SS, Berardi RS. Inflammatory pseudotumor of the lung. Ultrastructural and light microscopic study of a myxomatous variant.Cancer 1984;54:861–5.CrossRefPubMedGoogle Scholar
  31. 31.
    Barardi RS, Lee SS, Chen HP, Stines GJ. Inflammatory pseudotumors of the lung.Surg Gynecol Obstet 1983;156:89–96.Google Scholar
  32. 32.
    Matsubra O, Tan-Liu NS, Kenney RM, Mark EJ. Inflammatory pseudotumors of the lung: progression from organizaing pneumonia to fibrous histiocytoma or to plasma cell granuloma in 32 cases.Human Pathol 1988;19:807–14.CrossRefGoogle Scholar
  33. 33.
    Wu JP, Yunis EJ, Fetterman G, Jaeschke WF, Gilbert EF. Inflammatory pseudotumours of the abdomen: plasma cell granulomas.J Clin Pathol 1973;26:943–8.CrossRefPubMedGoogle Scholar
  34. 34.
    Vujanic GM, Milovanovic D, Aleksandrovic S. Aggressive inflammatory pseudotumor of the abdomen 9 years after therapy for Wilms' tumor: a complication, coincidence, or association?Cancer 1992;70:2362–6.CrossRefPubMedGoogle Scholar
  35. 35.
    Freud E, Bilik R, Yaniv I, et al.Arch Surg 1991;126:653–5.PubMedGoogle Scholar
  36. 36.
    Imperato JP, Folkman J, Sagerman RH, Cassady JR. Treatment of plasma cell granuloma of the lung with radiation therapy: a report of two cases and a review of the literature.Cancer 1986;57:2127–9.CrossRefPubMedGoogle Scholar
  37. 37.
    Hoover SV, Granston AS, Koch DF, Hudson TR. Plasma cell granuloma of the lung, response to radiation therapy: report of a single case.Cancer 1977;39:123–5.CrossRefPubMedGoogle Scholar
  38. 38.
    Masterson J, Woods D, Lau G, Dobranowski J. Case Report: Isolated colonic hemangioma in a child.Can Assoc Radiol J 1991;42:431–4.PubMedGoogle Scholar
  39. 39.
    Hansen U, Boesgaard S, Andersen J. Cavernous haemangioma of the jejunum: long-standing anaemia in a child.Acta Paediatr Scand 1990;79:1124–7.CrossRefPubMedGoogle Scholar
  40. 40.
    Malone PS, Kiely EM, Spitz L. Diffuse cavernous haemangioma of the rectum in childhood.Br J Surg 1990;77:338–9.CrossRefPubMedGoogle Scholar

Copyright information

© The Society of Surgical Oncology, Inc 1994

Authors and Affiliations

  • Michael A. Skinner
    • 1
    • 2
  • Donald A. Plumley
    • 1
    • 2
  • Jay L. Grosfeld
    • 1
    • 2
  • Frederick J. Rescorla
    • 1
    • 2
  • Karen W. West
    • 1
    • 2
  • L. R. Scherer
    • 1
    • 2
  1. 1.From the Section of Pediatric Surgery, Department of SurgeryIndiana University School of MedicineUSA
  2. 2.J. W. Riley Hospital for ChildrenIndianapolisUSA

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