Gastric tumors in children: single-center study with emphasis on treatment of repeated recurrence

Purpose Analysis of surgical management and survival of pediatric patients with gastric tumors treated at our institution. Methods A retrospective study of patients with primary gastric tumors treated between 1993 and 2018 was conducted. Results Eight patients, five girls and three boys, were diagnosed with gastric tumors at an average age of 10.4 years (1 day–15.4 years). Surgical management included Billroth type I procedure in five and tumor excision in three patients. Histology revealed gastrointestinal stromal tumor (GIST) in four patients and one of each of schwannoma, myofibroblastic tumor, hamartoma and teratoma. Microscopically clear margins were reported in six patients. Repeated local recurrence occurred in three patients (2 × GIST, 1 × myofibroblastic tumors) who consequently underwent three, four and six reoperations. One of these patients had liver metastases, which were managed with ligation of the hepatic arteries. This patient was also diagnosed with a lung hamartoma, which was treated with a lobectomy. Survival rate was 100% with a median follow-up of 8.6 years (7 months–25.5 years). Conclusions Gastric tumors are rare in children and represent a management challenge. Repeated recurrence of GISTs and myofibroblastic tumors remains frequent even after complete resection and may necessitate multiple surgeries, therefore patients require a lifelong follow-up.