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. 2014:2014:527471.
doi: 10.1155/2014/527471. Epub 2014 Jan 14.

Gastric adenocarcinoma presenting with gastric outlet obstruction in a child

Abdulrahman Al-Hussaini  1 , Salem Alghamdi  1 , Rasha Alsaaran  2 , Fawaz Al-Kasim  3 , Zakaria Habib  4 , Nouri Ourfali  1
Affiliations

Gastric adenocarcinoma presenting with gastric outlet obstruction in a child

Abdulrahman Al-Hussaini et al. Case Rep Gastrointest Med. 2014.

Abstract

Gastric carcinoma is extremely rare in children representing only 0.05% of all gastrointestinal malignancies. Here, we report the first pediatric case of gastric cancer presenting with gastric outlet obstruction. Upper endoscopy revealed a markedly thickened antral mucosa occluding the pylorus and a clean base ulcer 1.5 cm × 2 cm at the lesser curvature of the stomach. The narrowed antrum and pylorus underwent balloon dilation, and biopsy from the antrum showed evidence of Helicobacter pylori gastritis. The biopsy taken from the edge of the gastric ulcer demonstrated signet-ring-cell type infiltrate consistent with gastric adenocarcinoma. At laparotomy, there were metastases to the liver, head of pancreas, and mesenteric lymph nodes. Therefore, the gastric carcinoma was deemed unresectable. The patient died few months after initiation of chemotherapy due to advanced malignancy. In conclusion, this case report underscores the possibility of gastric adenocarcinoma occurring in children and presenting with gastric outlet obstruction.

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Figures

Figure 1
Figure 1
Fullness at epigastrium due to gastric distension.
Figure 2
Figure 2
Barium meal shows obstruction at pylorus (white arrow) and a crater of an ulcer (black arrow).
Figure 3
Figure 3
Ultrasound abdomen shows thickening of antral (asterisks) and pyloric wall.
Figure 4
Figure 4
Endoscopic view of obstruction at pylorus (long arrow) and a clean bed of an ulcer at lesser curvature (short arrow).
Figure 5
Figure 5
Histopathology of a biopsy form edge of the gastric ulcer shows signet-ring-cell infiltrate (arrows) consistent with gastric adenocarcinoma. (Hematoxylin and eosin staining; magnification ×40).
See this image and copyright information in PMC

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