Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3409
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
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.
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.