Published online Dec 7, 2021. doi: 10.3748/wjg.v27.i45.7844
Peer-review started: August 9, 2021
First decision: August 29, 2021
Revised: September 11, 2021
Accepted: November 24, 2021
Article in press: November 24, 2021
Published online: December 7, 2021
The incidence of gastric Burkitt lymphoma (BL), presenting as paraplegia and acute pancreatitis, is extremely low. BL is a great masquerader that presents in varied forms and in atypical locations, and it is prone to misdiagnosis and missed diagnosis. The prognosis of BL remains poor because of the difficulty in early diagnosis and the limited advances in chemotherapy.
A 53-year-old man was referred to our hospital from the local county hospital due to abdominal pain for two weeks and weakness in the lower extremities for one day. Magnetic resonance imaging of the abdomen and lumbar spine showed a swollen pancreas and gallbladder, with peripancreatic exudation and liquid collection, indicating acute pancreatitis and acute cholecystitis. Additionally, we observed abnormally thickened lesions of the gastric wall, multiple enlarged retroperitoneal lymph nodes and a well-demarcated, posterolateral extradural mass lesion between T9 and T12, with extension through the spinal foramen and definite bony destruction, suggesting metastasis in gastric malignancy. Subse
Clinicians should be aware that BL can be the potential cause of acute pancreatitis or a rapidly progressive spinal tumor with accompanying paraplegia. For gastric BL, gastroscopy biopsies and pathology are necessary for a definite diagnosis.
Core Tip: The incidence of Burkitt lymphoma (BL) is extremely low, and the clinical symptoms are atypical. The misdiagnosis rate is high, and the patient's prognosis is poor. The patient in this case was eventually diagnosed with BL involving the stomach, pancreas and vertebral column presenting with acute pancreatitis and neurological symptoms secondary to compression of the spinal cord. Chemotherapeutic treatment was refused by the patient, and he eventually died after one week due to upper gas