ALIMENTARY-TRACT MALIGNANCIES IN CHILDREN

Alimentary tract. malignancies in children are unusual. From 1952 to 1 996, 54 patients (55 cases) underwent surgery at The Children's Hospit al, Columbus for intestinal malignancy. Their records were reviewed re trospectively. The mean age at diagnosis was 9.3 years (range, 1 to 17 years). There were 35 boys and 19 girls (M:F ratio, 1:8). Mean follow -up was 108 months. Laparotomy was performed in all but one child. The primary tumor sites included the colon (31 cases), small bowel (12 ca ses), appendix (9 cases), and stomach (3 cases). Seventy-five percent of the tumors were non-Hodgkin's lymphomas (41 cases), followed by app endiceal carcinoid (9 cases), colon adenocarcinoma (3 cases), and gast ric sarcoma (2 cases). Lymphoma occurred in 28 of 31 nonappendiceal la rge bowel tumors and was the only tumor type seen in the small intesti ne. There were 21 Burkitt's, 11 lymphoblastic, 6 small cell, and 5 lar ge cell lymphomas. There was a statistically significant increase in t he frequency of small bowel lymphoma after 1982 (10 of 20) in comparis on with that before 1982 (2 of 21), P <.05. This coincided with an inc rease in Burkitt's lymphoma from 5 of 27 (pre-1982) to 16 of 20 (post- 1982), and a decrease in lymphoblastic lymphomas from 7 of 21 (pre-198 2) to 2 of 20 (post-1982), P <.05. Localized disease and complete rese ction favored survival in lymphoma, whereas age, sex, and urgency of o peration had no influence on survival. This study highlights the predo minance of lymphoma as the most common small and large bowel tumor and highlights the emergence of nonendemic Burkitt's as a major entity in pediatric intestinal malignancy. Copyright (C) 1997 by W.B. Saunders Company.