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Case Report
Medwave 2019;19(7):e7674 doi: 10.5867/medwave.2019.07.7674
Ovarian Burkitt lymphoma as the primary manifestation: A case report and literature review
Ana Gómez Alarcón, María Nieves Quesada Fernández, Fátima Parras Onrubia, María Dolores Díaz Serrano, José Quesada Villar, José Fernando Hernández Aznar
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Key Words: burkitt lymphoma, ovarian neoplasms, proto-oncogene proteins c-myc

Abstract

Ovarian involvement as the initial manifestation of a Burkitt lymphoma without detectable extra-ovarian disease is rare, which is why it is usually not included in the differential diagnosis when an ovarian tumor is detected. A missed diagnosis will lead to the wrong treatment being given, and this can compromise any future reproductive wishes of the patient. In this article, a patient presents a Burkitt lymphoma with ovarian involvement as an initial manifestation and an unusually rapid systemic progression of the disease. Prompted by this case and its unusual course, we reviewed the existing literature.


 

Only Spanish version is available. 



Licencia Creative Commons Esta obra de Medwave está bajo una licencia Creative Commons Atribución-NoComercial 3.0 Unported. Esta licencia permite el uso, distribución y reproducción del artículo en cualquier medio, siempre y cuando se otorgue el crédito correspondiente al autor del artículo y al medio en que se publica, en este caso, Medwave.

 

La afectación ovárica como debut de un linfoma de Burkitt sin enfermedad extraovárica detectable es anecdótica, por lo que habitualmente no se incluye como hipótesis diagnóstica tras el hallazgo de una tumoración ovárica. Su desconocimiento lleva a realizar un tratamiento equivocado que puede llegar a comprometer el deseo reproductivo de la paciente. Presentamos el caso de una paciente que presenta un linfoma de Burkitt con afectación ovárica como manifestación inicial. La paciente desarrolló una progresión sistemática excepcionalmente rápida. A propósito de este caso y de su inusual evolución, revisamos la literatura existente.

Authors: Ana Gómez Alarcón[1], María Nieves Quesada Fernández[1], Fátima Parras Onrubia[1], María Dolores Díaz Serrano[2], José Quesada Villar[1], José Fernando Hernández Aznar[3]

Affiliation:
[1] Servicio de Obstetricia y Ginecología del Hospital Virgen del Castillo, Yecla, España
[2] Servicio de Obstetricia y Ginecología del Hospital General de Albacete, Albacete, España
[3] Servicio de Anatomía Patológica del Hospital Virgen del Castillo, Yecla, España

E-mail: ana.gomez.quint@hotmail.com

Author address:
[1] Avda. Feria SN
CP 30510
Yecla (Murcia)
España

Citation: Gómez Alarcón A, Quesada Fernández MN, Parras Onrubia F, Díaz Serrano MD, Quesada Villar J, Hernández Aznar JS. Ovarian Burkitt lymphoma as the primary manifestation: A case report and literature review. Medwave 2019;19(7):e7674 doi: 10.5867/medwave.2019.07.7674

Submission date: 5/11/2018

Acceptance date: 24/6/2019

Publication date: 7/8/2019

Origin: not commissioned

Type of review: reviewed by four external peer reviewers, double-blind

PubMed record

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  1. Jaffe ES, Harris NL, Stein H, Isaacson PG. Classification of lymphoid neoplasms: the microscope as a tool for disease discovery. Blood. 2008 Dec 1;112(12):4384-99. | CrossRef | PubMed |
  2. Ferry JA. Burkitt’s lymphoma: Clinicopathologic features and differential diagnosis. Oncologist 2006; 11: 375-383. | CrossRef |
  3. Swerdlow SH, Campo E, Harris NL. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (4th ed). Lyon, France: International Agency for Research on Cancer; 2008. | Link |
  4. Dalla-Favera R. Molecular genetics of aggressive B-cell lymphoma. Hematol Oncol. 2017 Jun;35 Suppl 1:76-79. | CrossRef | PubMed |
  5. Molyneux EM, Rochford R, Griffin B, Newton R, Jackson G, Menon G, et al. Burkitt's lymphoma. Lancet. 2012 Mar 31;379(9822):1234-44. | CrossRef | PubMed |
  6. Haralambieva E, Boerma EJ, van Imhoff GW, Rosati S, Schuuring E, Müller-Hermelink HK, et al. Clinical, immunophenotypic, and genetic analysis of adult lymphomas with morphologic features of Burkitt lymphoma. Am J Surg Pathol. 2005 Aug;29(8):1086-94. | PubMed |
  7. Rostion CG. Mesenteric adenitis and gynecological problems that cause acute abdominal pain. Medwave 2005 Ene;5(1):e1948. | CrossRef |
  8. Monterroso V, Jaffe ES, Merino MJ, Medeiros LJ. Malignant lymphomas involving the ovary. A clinicopathologic analysis of 39 cases. Am J Surg Pathol. 1993 Feb;17(2):154-70. | PubMed |
  9. Crawshaw J, Sohaib SA, Wotherspoon A, Shepherd JH. Primary non-Hodgkin's lymphoma of the ovaries: imaging findings. Br J Radiol. 2007 Aug;80(956):e155-8. | CrossRef | PubMed |
  10. Chishima F, Hayakawa S, Ohta Y, Sugita K, Yamazaki T, Sugitani M, Yamamoto T: Ovarian Burkitt´s lymphoma diagnosed by a combination of clinical features, morphology, immunophenotype, and molecular findings and successfully managed with surgery and chemotherapy. J Gynecol Cancer 2006, 16(1):337-343. | CrossRef |
  11. Fox H, Langley FA (eds): Malignant lymphoma of ovary. In: Tumors of the ovary. London: Heinemann, 1976: 293-9. | Link |
  12. Fox H, Langley FA, Govan AD, Hill AS, Bennett MH. Malignant lymphoma presenting as an ovarian tumour: a clinicopathological analysis of 34 cases. Br J Obstet Gynaecol. 1988 Apr;95(4):386-90. | PubMed |
  13. Chorlton I, Norris HJ, King FM. Malignant reticuloendothelial disease involving the ovary as a primary manifestation: a series of 19 lymphomas and 1 granulocytic sarcoma. Cancer. 1974 Aug;34(2):397-407. | PubMed |
  14. Arseneau JC, Canellos GP, Banks PM, Berard CW, Gralnick HR, DeVita VT Jr: American Burkitt’s lymphoma: a clinicopathologic study of 30 cases. I. Clinical factors relating to prolonged survival. Am J Med 1975; 58: 314-321. | PubMed |
  15. Vang R, Medeiros LJ, Warnke RA, Higgins JP, Deavers MT: Ovarian non-Hodgkin’s lymphoma: a clinicopathologic study of eight primary cases. Mod Pathol 2001; 14: 1093-1099. | CrossRef |
  16. Baloglu H, Turken O, Tutuncu L, Kizilkaya E. 24-year-old female with amenorhea: bilateral primary ovarian Burkitt lymphoma. Gynecol Oncol. 2003 Nov;91(2):449-51. | PubMed |
  17. Chishima F, Hayakawa S, Ohta Y, Sugita K, Yamazaki T, Sugitani M, et al. Ovarian Burkitt's lymphoma diagnosed by a combination of clinical features, morphology, immunophenotype, and molecular findings and successfully managed with surgery and chemotherapy. Int J Gynecol Cancer. 2006 Jan-Feb;16 Suppl 1:337-43. | PubMed |
  18. Lu SC, Shen WL, Cheng YM, Chou CY, Kuo PL. Burkitt'S lymphoma mimicking a primary gynecologic tumor. Taiwan J Obstet Gynecol. 2006 Jun;45(2):162-6. | PubMed |
  19. Ng SP, Leong CF, Nurismah MI, Shahila T, Jamil MA. Primary Burkitt lymphoma of the ovary. Med J Malaysia. 2006 Aug;61(3):363-5. | PubMed |
  20. Crawshaw J, Sohaib SA, Wotherspoon A, Shepherd JH. Primary non-Hodgkin's lymphoma of the ovaries: imaging findings. Br J Radiol. 2007 Aug;80(956):e155-8. | PubMed |
  21. Muñoz Martín AJ, Pérez Fernández R, Viñuela Beneítez MC, Martínez Marín V, Marquéz-Rodas I, Sabin Domínguez P, et al. Primary ovarian Burkitt lymphoma. Clin Transl Oncol. 2008 Oct;10(10):673-5. | PubMed |
  22. Gutiérrez-García L, Medina Ramos N, García Rodríguez R, Barber MA, Arias MD, García JA. Bilateral ovarian Burkitt's lymphoma. Eur J Gynaecol Oncol. 2009;30(2):231-3. | PubMed |
  23. Cui T, Wang C, He H, Shi G, Hu L. A rare case of ovarian Burkitt lymphoma associated tumor lysis syndrome. Eur J Gynaecol Oncol. 2010;31(2):209-10. | PubMed |
  24. Cyriac S, Srinivas L, Mahajan V, Sundersingh S, Sagar TG. Primary Burkitt's lymphoma of the ovary. Afr J Paediatr Surg. 2010 May-Aug;7(2):120-1. | CrossRef | PubMed |
  25. Yun J, Kim SJ, Won JH, Choi CW, Eom HS, Kim JS, et al. Clinical features and prognostic relevance of ovarian involvement in non-Hodgkin's lymphoma: A Consortium for Improving Survival of Lymphoma (CISL) report. Leuk Res. 2010 Sep;34(9):1175-9. | CrossRef | PubMed |
  26. Shacham-Abulafia A, Nagar R, Eitan R, Levavi H, Sabah G, Vidal L, et al. Burkitt's lymphoma of the ovary: case report and review of the literature. Acta Haematol. 2013;129(3):169-74. | CrossRef | PubMed |
Jaffe ES, Harris NL, Stein H, Isaacson PG. Classification of lymphoid neoplasms: the microscope as a tool for disease discovery. Blood. 2008 Dec 1;112(12):4384-99. | CrossRef | PubMed |

Ferry JA. Burkitt’s lymphoma: Clinicopathologic features and differential diagnosis. Oncologist 2006; 11: 375-383. | CrossRef |

Swerdlow SH, Campo E, Harris NL. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (4th ed). Lyon, France: International Agency for Research on Cancer; 2008. | Link |

Dalla-Favera R. Molecular genetics of aggressive B-cell lymphoma. Hematol Oncol. 2017 Jun;35 Suppl 1:76-79. | CrossRef | PubMed |

Molyneux EM, Rochford R, Griffin B, Newton R, Jackson G, Menon G, et al. Burkitt's lymphoma. Lancet. 2012 Mar 31;379(9822):1234-44. | CrossRef | PubMed |

Haralambieva E, Boerma EJ, van Imhoff GW, Rosati S, Schuuring E, Müller-Hermelink HK, et al. Clinical, immunophenotypic, and genetic analysis of adult lymphomas with morphologic features of Burkitt lymphoma. Am J Surg Pathol. 2005 Aug;29(8):1086-94. | PubMed |

Rostion CG. Mesenteric adenitis and gynecological problems that cause acute abdominal pain. Medwave 2005 Ene;5(1):e1948. | CrossRef |

Monterroso V, Jaffe ES, Merino MJ, Medeiros LJ. Malignant lymphomas involving the ovary. A clinicopathologic analysis of 39 cases. Am J Surg Pathol. 1993 Feb;17(2):154-70. | PubMed |

Crawshaw J, Sohaib SA, Wotherspoon A, Shepherd JH. Primary non-Hodgkin's lymphoma of the ovaries: imaging findings. Br J Radiol. 2007 Aug;80(956):e155-8. | CrossRef | PubMed |

Chishima F, Hayakawa S, Ohta Y, Sugita K, Yamazaki T, Sugitani M, Yamamoto T: Ovarian Burkitt´s lymphoma diagnosed by a combination of clinical features, morphology, immunophenotype, and molecular findings and successfully managed with surgery and chemotherapy. J Gynecol Cancer 2006, 16(1):337-343. | CrossRef |

Fox H, Langley FA (eds): Malignant lymphoma of ovary. In: Tumors of the ovary. London: Heinemann, 1976: 293-9. | Link |

Fox H, Langley FA, Govan AD, Hill AS, Bennett MH. Malignant lymphoma presenting as an ovarian tumour: a clinicopathological analysis of 34 cases. Br J Obstet Gynaecol. 1988 Apr;95(4):386-90. | PubMed |

Chorlton I, Norris HJ, King FM. Malignant reticuloendothelial disease involving the ovary as a primary manifestation: a series of 19 lymphomas and 1 granulocytic sarcoma. Cancer. 1974 Aug;34(2):397-407. | PubMed |

Arseneau JC, Canellos GP, Banks PM, Berard CW, Gralnick HR, DeVita VT Jr: American Burkitt’s lymphoma: a clinicopathologic study of 30 cases. I. Clinical factors relating to prolonged survival. Am J Med 1975; 58: 314-321. | PubMed |

Vang R, Medeiros LJ, Warnke RA, Higgins JP, Deavers MT: Ovarian non-Hodgkin’s lymphoma: a clinicopathologic study of eight primary cases. Mod Pathol 2001; 14: 1093-1099. | CrossRef |

Baloglu H, Turken O, Tutuncu L, Kizilkaya E. 24-year-old female with amenorhea: bilateral primary ovarian Burkitt lymphoma. Gynecol Oncol. 2003 Nov;91(2):449-51. | PubMed |

Chishima F, Hayakawa S, Ohta Y, Sugita K, Yamazaki T, Sugitani M, et al. Ovarian Burkitt's lymphoma diagnosed by a combination of clinical features, morphology, immunophenotype, and molecular findings and successfully managed with surgery and chemotherapy. Int J Gynecol Cancer. 2006 Jan-Feb;16 Suppl 1:337-43. | PubMed |

Lu SC, Shen WL, Cheng YM, Chou CY, Kuo PL. Burkitt'S lymphoma mimicking a primary gynecologic tumor. Taiwan J Obstet Gynecol. 2006 Jun;45(2):162-6. | PubMed |

Ng SP, Leong CF, Nurismah MI, Shahila T, Jamil MA. Primary Burkitt lymphoma of the ovary. Med J Malaysia. 2006 Aug;61(3):363-5. | PubMed |

Crawshaw J, Sohaib SA, Wotherspoon A, Shepherd JH. Primary non-Hodgkin's lymphoma of the ovaries: imaging findings. Br J Radiol. 2007 Aug;80(956):e155-8. | PubMed |

Muñoz Martín AJ, Pérez Fernández R, Viñuela Beneítez MC, Martínez Marín V, Marquéz-Rodas I, Sabin Domínguez P, et al. Primary ovarian Burkitt lymphoma. Clin Transl Oncol. 2008 Oct;10(10):673-5. | PubMed |

Gutiérrez-García L, Medina Ramos N, García Rodríguez R, Barber MA, Arias MD, García JA. Bilateral ovarian Burkitt's lymphoma. Eur J Gynaecol Oncol. 2009;30(2):231-3. | PubMed |

Cui T, Wang C, He H, Shi G, Hu L. A rare case of ovarian Burkitt lymphoma associated tumor lysis syndrome. Eur J Gynaecol Oncol. 2010;31(2):209-10. | PubMed |

Cyriac S, Srinivas L, Mahajan V, Sundersingh S, Sagar TG. Primary Burkitt's lymphoma of the ovary. Afr J Paediatr Surg. 2010 May-Aug;7(2):120-1. | CrossRef | PubMed |

Yun J, Kim SJ, Won JH, Choi CW, Eom HS, Kim JS, et al. Clinical features and prognostic relevance of ovarian involvement in non-Hodgkin's lymphoma: A Consortium for Improving Survival of Lymphoma (CISL) report. Leuk Res. 2010 Sep;34(9):1175-9. | CrossRef | PubMed |

Shacham-Abulafia A, Nagar R, Eitan R, Levavi H, Sabah G, Vidal L, et al. Burkitt's lymphoma of the ovary: case report and review of the literature. Acta Haematol. 2013;129(3):169-74. | CrossRef | PubMed |