Related Experiment Videos
Gastric carcinoma in children
T W McGill1, E C Downey, J Westbrook
1Department of Surgery, Naval Hospital San Diego, CA.
Insights
Pediatric gastric carcinoma is rare but presents like adult cancer. Early diagnosis and multimodal treatment, including surgery and chemotherapy, offer hope for long-term survival in children.
Area of Science:
- Pediatric Oncology
- Gastrointestinal Malignancies
Background:
- Primary gastric carcinoma is a rare malignancy in children, accounting for only 0.05% of pediatric gastrointestinal cancers.
- Childhood gastric carcinoma shares similarities in pattern, presentation, and location with adult gastric carcinoma.
- Diagnosis requires a high index of suspicion in children presenting with symptoms mimicking acid peptic disease, with delays being common.
Observation:
- Early upper gastrointestinal radiography and endoscopy with biopsy are crucial for timely diagnosis.
- Surgical therapy alone may offer palliative benefits but has not historically led to long-term survival.
- The roles of chemotherapy and radiation in pediatric gastric carcinoma are not well-defined, though adult studies suggest potential regimens.
Findings:
- A rare case of a 3-year disease-free survivor is presented.
- Treatment involved surgical resection combined with chemotherapy.
- This case highlights the potential for successful long-term outcomes with multimodal therapy.
Implications:
- Multimodal treatment strategies, including surgery and chemotherapy, may improve long-term survival rates in pediatric gastric carcinoma.
- Further research is needed to define the optimal role of chemotherapy and radiation in managing this rare pediatric malignancy.
- Increased awareness and early diagnostic interventions are critical for improving outcomes in children with gastric cancer.
Abstract:
Primary gastric carcinoma accounts for only 0.05% of pediatric gastrointestinal malignancies. The pattern, presentation, and location of childhood gastric carcinoma are similar to those of adult gastric carcinoma. Diagnosis is based on a high index of suspicion in children who present with symptoms mimicking acid peptic disease. Delay in diagnosis is common and avoided by early upper gastrointestinal radiography and endoscopy with biopsy. Surgical therapy alone may prolong survival but thus far it has proven only palliative. The role of chemotherapy and radiation in gastric carcinoma is still not well defined, although some new studies in adults may support the use of etoposide, doxorubicin, and cisplatin as primary therapy or combined with surgery and radiation. Long-term survival in children is rare. We present the case of a 3-year survivor, free of disease, treated with resection and chemotherapy.