Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2015; 21(11): 3409-3413
Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3409
Pediatric gastric cancer presenting with massive ascites
Chien-Heng Lin, Wei-Ching Lin, I-Hsiu Lai, Shu-Fen Wu, Kang-Hsi Wu, An-Chyi Chen
Chien-Heng Lin, I-Hsiu Lai, Shu-Fen Wu, Kang-Hsi Wu, An-Chyi Chen, Department of Pediatrics, Children’s Hospital, China Medical University Hospital, Taichung 404, Taiwan
Wei-Ching Lin, Shu-Fen Wu, An-Chyi Chen, College of Medicine, School of Medicine, China Medical University, Taichung 404, Taiwan
Kang-Hsi Wu, College of Chinese Medicine, School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
Wei-Ching Lin, Department of Radiology, China Medical University Hospital, Taichung 404, Taiwan
Author contributions: Lin CH is the main author of this article; Chen AC performed the majority of experiments; Lin WC provided vital reagents and analytical tools and also the description of the imaging; Wu SF and Wu KH were attending doctors and performed clinical treatment and were also involved in editing the manuscript; Lai IH provided the collection of all the human materials; all authors have reviewed the manuscript and approved the final manuscript.
Supported by grants from the Research laboratory of pediatrics, Children’s Hospital of China Medical University; and China Medical University Hospital, No. DMR-101-042.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: An-Chyi Chen, MD, Department of Pediatrics, Children’s Hospital, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung 404, Taiwan. d8427@mail.cmuh.org.tw
Telephone: +886-4-22052121 Fax: +886-4-22032798
Received: September 9, 2014
Peer-review started: September 9, 2014
First decision: October 14, 2014
Revised: October 23, 2014
Accepted: November 11, 2014
Article in press: November 11, 2014
Published online: March 21, 2015
Processing time: 191 Days and 9.3 Hours
Abstract

Gastric adenocarcinoma is quite rare in children and as a result very little experience has been reported on with regards to clinical presentation, treatment and outcome. We describe the case of a 16-year-old boy presenting with abdominal fullness and poor appetite for 7 d. Sonography showed massive ascites and computed tomography imaging revealed the presence of gastric mucosa thickness with omentum caking. The diagnosis of gastric adenocarcinoma was biopsy-proven endoscopically. Despite gastric adenocarcinoma being quite rare in the pediatric patient population, we should not overlook the possibility of gastric adenocarcinoma when a child presents with distended abdomen and massive ascites.

Keywords: Gastric adenocarcinoma; Ascites; Children

Core tip: Gastric adenocarcinoma is rare in pediatric patient. It should be suspected in a child with gastric ulcers and massive ascites. Upper gastrointestinal endoscopy and endoscopic biopsies are crucial in children with vague gastrointestinal symptoms and massive ascites in whom CT fails to demonstrate the primary site of the malignancy.