Gastric Adenocarcinoma in a 16-Year-Old Female

Abstract

Background: Primary gastric adenocarcinoma commonly occurs in the elderly in the sixth to seventh decade of life but is exceedingly rare in children and adolescents, accounting for only 0.05% of pediatric gastrointestinal malignancies. Because of the nonspecific clinical presentation, gastric adenocarcinomas in children and adolescents are often metastatic when they are discovered.

Case report: We describe a case of gastric adenocarcinoma in a 16-year-old female who was diagnosed early and successfully treated with surgery and chemoradiation by volumetric modulated arc technique.

Conclusion: The possibility of gastric adenocarcinoma should be considered in children and adolescents with persistent nonspecific symptoms of vomiting and upper abdominal pain so that the diagnosis can be made at early stages and radical treatment can be offered.

Keywords: Adolescent; chemotherapy; gastric cancer; pediatrics; radiotherapy–conformal.

Figure 1.. Contrast-enhanced computed tomography of the abdomen shows antropyloric thickening of the stomach (arrow).

Figure 2.. Histopathology. A. Gastric mucosa is infiltrated by sheets of tumor cells with signet ring cell morphology exhibiting abundant intracytoplasmic mucin (hematoxylin and eosin stain, × 200). B. Tumor cells infiltrate the submucosa of the stomach, highlighted by pan cytokeratin immunohistochemistry (diaminobenzidine stain, DAKO monoclonal antihuman antibody, × 100). C. Tumor cells exhibit abundant intracytoplasmic mucin infiltrating the muscular layer (hematoxylin and eosin stain, × 200).

Figure 3.. Conformal radiotherapy planning by volumetric modulated arc technique showing dose distribution in (A) axial, (B) coronal, and (C) sagittal planes, as well as (D) the dose-volume histogram.