Primary Burkitt Lymphoma of the Rectum

Abstract

Burkitt lymphoma (BL) is a highly aggressive mature B-cell neoplasm with the highest incidence in a pediatric population. Three clinical subtypes of BL are known: sporadic, endemic, and immune deficiency associated. The most common site of involvement in the case of the sporadic form is an ileocecal region. We describe a rare case of sporadic BL in a 71-year-old male with a primary localisation in the rectum presenting with progressive bowel obstruction and rectal bleeding. The clinical evaluation involved colonoscopy, biopsy with a following morphological examination, computerised tomography of thorax, abdomen and pelvis, magnetic resonance imaging of pelvis, and laboratory analysis. Due to the unclear tumorous mass and progressive clinical symptoms, surgical treatment was applied – laparotomy, total mesorectal excision with the formation of permanent colostomy. Morphological examination of the specimen revealed a phenotype characteristic to BL. One month after the surgery, two single liver metastasis were detected. The patient received six courses of DA-EPOCH chemotherapy. Post-treatment radiological examinations revealed full clinical remission and disease-free survival for 68 months (5 years and 8 months).