Non-Essential Intervention in the Management of Ovarian Burkitt Lymphoma: A Case Report
Asian Hematology Research Journal,
Background: Ovarian involvement by Non-Hodgkins Lymphoma (NHL) may manifest within the four subtypes of lymphoma: diffuse large B-cell lymphoma, Burkitt lymphoma, lymphoblastic lymphoma, or anaplastic large cell lymphoma. Burkitt Lymphoma (BL) rarely manifests as a primary ovarian disease given the various epidemiological studies, putting the incidence at 0.5% of NHL and 1.5% of all ovarian neoplasm.
Objective: This study is intended to highlight necessary intervention in the event of an uncommon manifestation of Burkitt lymphoma in a milieu of diagnostic challenges.
Methods: A comprehensive review, and analysis of diagnosis, intervention and treatment of the index case was conducted by a team of health caregivers of the Federal Medical Centre, Bida, North Central Nigeria.
Results: This review identifies a 15-year old female, with features suggestive of abdominal malignancy. In view of the associated severe abdominal discomfort, and pressure effects arising from the huge abdominal mass, the patient underwent exploratory laparotomy partly as a palliative measure to debulk as well as determining the extent of the local disease spread, and obtain tissue for histology. Following a histological diagnosis of ovarian Burkitt lymphoma stage IIIB (St. Jude / Murphys staging), the patient was commenced on supportive therapy; a monthly course of intensive multi-agent (cyclophosphamide, Vincristine, Methotrexate) chemotherapy including intrathecal Methotrexate prophylaxis. Haematologic remission was achieved by the end of the fifth cycle of the scheduled six cycles. Patient is currently well, and on hormone replacement therapy while being followed up at both the haematology and gynaecology clinics.
Conclusion: Burkitt lymphoma (BL) as we have and seen in this case is highly responsive to standard high-dose chemotherapy, but it could be rapidly fatal if treatment is delayed. Although surgery is not considered as first line of treatment, but offers an opportunity for debulking and obtaining tissue biopsy for histological analysis. Standard multi-agent chemotherapeutic management remains the recommended first line choice in established case.
- Ovarian burkitt lymphoma
- surgical intervention
- Intensive multi-agent chemotherapy
- haematologic remission
- Limited diagnostic tools
How to Cite
Durosinmi MA. Burkitt Lymphoma: A potentially curable childhood tumour: Experience in Ile-Ife, Nigeria (1986-2014). Annals of Health Research. 2016: 2(1)
Jason MG, Haque A. Burkitt Lymphoma: Pathogenesis and immune evasion. Journal of oncology; 2010 [cited 19 June 2021].
Ali HK, Ronald AS. Burkitt Lymphoma and Burkitt-like Lymphoma; 2019.
Al-Maghrabi H, Meliti A. Primary bilateral ovarian Burkitt lymphoma; a rare issue in gynecologic oncology. J Surg Case Rep. 2018. 2018;(5): rjy113
[Cited 31 May 2021].
Oguonu T, Emodi I, Kaine W. Epidemiology of Burkitts lymphoma in Enugu, Nigeria.Ann Trop Paediatr; 2002. 22(4):369-74.
Manganaro L, Bernardo S, Eleonora SM, Sollazzo P, Vinci V, Alessandra De G, et al. Burkitts Lymphoma Presented as Advanced Ovarian Cancer without Evidence of Lymphadenopathy: CT and MRI Findings. Case Report; 2013 [31 May 2021].
Noriko M, Yoichi K, Yoshiko N, Mai M, Hironori M, Mitsutoshi I. Burkitt lymphoma of the ovary: A case report and literature review. The Journal of Obstetrics and Gynaecology Research; 2013 [01 June 2021].
Shacham-Abulafia A. Nagar R. Eitan E. Levavi H. Sabah G. Vidal L et al. Burkitts lymphoma of the Ovary: Case Report and Review of the Literature. Acta Haematol; 2013. 129:169–174 [cited 01 June 2021].
Aditi G, Harshad A, Sharad A, Amarjeet S. Bilateral ovarian primary Burkitts lymphoma in a child: A clinico-radio-pathological evaluation. Med J DY Patil Univ; 2015;8:223-6.
Mondal SK, Bera H, Mondal S, Samanta TK. Primary bilateral ovarian Burkitts lymphoma in a six-year-old child: Report of a rare malignancy. J Can Res Ther. 2014;10:755-7.
Stepniak A, Piotr C, Piotr S, Ewa W, Slawomir W, Tomasz P. Primary ovarian Burkitts lymphoma: a rare oncological problem in gynaecology: a review of literature. Arch Gynecol Obstet. 2017;296(4):653–660 [cited 24 May 2021].
Available:www.ncbi.nih.gov/pmc/articles/PMC5591814# doi: 10.1007/s00404-017-4478-6.
Oluwasola AO, Olaniyi JA, Otegbayo JA, Ogun GO, Akingbola TS, Ukah CO et al. A Fifteen-year Review of Lymphomas in a Nigerian Tertiary Healthcare Centre. Health Popul Nutr. 2011;29(4):310–316.
Perkins AS, Friedberg JW. Burkitt lymphoma in Adults; 2000. Haematology.
Robert MA, Nathaniel K, Daniel JS. Paediatrics gastrointestinal Neoplasm; 2018.
Shih-Sung C, Hongtao Y, Ming-Qing D, Chin-Li L, Ahmet D, Pin-Pen H et al. Histopathology and Immunohistochemistry in distinguishing Burkitt lymphoma from diffuse large b-cell lymphoma with very high proliferative index and with or without a starry-sky pattern. A comparative study with EBER and FISH. Am J Clin Pathol; 2007. 128:558564
[Cited 20 May 2021].
American Cancer Society. Non-Hodgkin Lymphoma in Children: Early Detection, Diagnosis, and Staging. Available from: Cancer.org |1.800.227.2345
Bianchi P, Torcia F, Vitali M, Cozza G, Matteoli M, Giovanale V. An atypical presentation of sporadic ovarian Burkitts lymphoma: case report and review of the literature. J Ovarian Res. 2013;6:46.
Lewis SM. Reference ranges and Normal Values. In Practical Haematology edited by Lewis SM, Bain BJ and Imelda Bates, 8th ed. 9–18.
William LR, Gwendolyn AM, Carl AB, David EB. Reference information for Clinical Laboratory In: Tietz Textbook of Clinical Chemistry on Molecular diagnostic. ed. Carl A.B, Edward RA, David EB. 4th ed. 2251– 2301.
Abstract View: 37 times
PDF Download: 11 times