It started as a minor swelling around his left breast. He was a bright, enthusiastic teenager who loved playing soccer, reading adventure books, and spending time with his friends. He went on with normal tasks even going to school and church. The swelling gained momentum and not so long, people noticed his left breast was larger than the right. As soon as his classmates noticed the changes in his body, whispers and laughter followed him wherever he went. His once vibrant social life became overshadowed by the cruel taunts and teasing of his peers. The stigma surrounding his condition left him feeling embarrassed and ashamed, causing him to withdraw from activities he once enjoyed. Struck by stigma, he could no longer go out and mingle with his peers.
After seeking medical attention in various facilities, he landed at The Savannah Hospital in Upperhill. His life took an unexpected turn when he was diagnosed with Burkitt’s lymphoma, a rare and aggressive form of cancer. Burkitt’s lymphoma is a highly aggressive non-Hodgkin’s lymphoma that can affect various parts of the body including breast. This sarcoma is identified as a rapidly fatal malignant lymphoma syndrome and 50% of all malignant tumors in children. However, breast involvement has not been documented. It commonly involves the jaw, facial bones, retroperitoneum, and abdominal viscera. The disease typically affects young patients in areas of high incidence, such as the jaw, whereas visceral involvement is more common in older patients in low-incidence areas. It is worth noting that breast involvement is extremely rare in Burkitt’s lymphoma.
This 19-year-old male presented to our emergency department with a left breast swelling for 2 months associated with drenching night sweats, weight loss and evening fevers. Physical examination revealed a mass measuring approximately 15 × 16 × 15 cm in the widest dimension, skin hyperpigmentation, no nipple discolorations, discharges, and non-tender on palpation. Biopsy was done, and the histology report revealed lymphocytes with a high mitotic rate and frequent apoptotic bodies showing a starry-sky appearance.
The patient underwent a pre-chemotherapy workup that included a lumber puncture for cerebral spinal fluid analysis to rule out central nervous system involvement, various blood tests, chest CT Scan (which showed no pulmonary metastases). He was put on medication that saw the swelling subside significantly and is doing better each day. We appreciate Dr. Kato and The Savannah Hospital for walking the journey with this vulnerable boy. The team has mobilised friends, family, peers and communities to offer the required support because we know that together we can achieve almost anything. We know anyone can get cancer, but not everyone has the same access to cancer care. We appreciate the efforts done by the Kenyan Ministry of Health in supporting Cancer patients and urge the Kenyan Government to ensure equality in Cancer Care for all.
Research article done by:
Dr kato Ronald et al. A rare case of Burkitt’s lymphoma of the breast in a 19-year-old male: Case report. Clin Case Rep. 2023 Oct 17;11(10):e8081. http://doi.org/10.1002/ccr3.8081. PMID: 37854259; PMCID: PMC10580697.
Storyline by Celestine Nasimiyu.