Host Defences To Burkitt Tumour
Ngu V. A. (1967). Host defences to Burkitt tumour. British medical journal, 1(5536), 345–347. https://doi.org/10.1136/bmj.1.5536.345
View Original Source →Case Details
Disease Location
Left cheek and right eye lid maxillae and mandibles
Personal Characteristics
4 -year-old male african
Clinical Characteristics
Admitted on 2 september 1965 with a 20 day history of swelling of the left cheek and right upper eyelid and some respiratory difficulty he was very ill, weighing 22lbs with bilateral involvement of both maxillae and both mandibles by tumor masses the maxillary tumor had ulcerated into the nostrils, from which a moderatee amount of bleeding was observed. Nasal obstruction and extension of tumor into the mouth had rendered normal breathing difficult. A tracheostomy was established, the perlorbital tissues were involved by tumor, more extensively on the right side than on the left x-ray of the facial bones showed extensive destruction of both maxillae and mandibles with displacement of the teeth, there was a loss of dental lamina dura biopsy of the left cheek tumor showed the presence of burkitt tumor cells on 3 september, he received a transfusion of 150ml of immune plasma i (plasma donor information is in article) because of occasional epistaxes and a hemoglobin of 6.9g/100ml, he was transfused with 350ml of whole blood obtained from a local adult nigerian with no history of burightkitt's he remained well until 26 september, about 3 weeks after the plasma infusion, when it was noticed that the tumor in the left cheek had recurred. A week later, the tumor was 3cm in diameter and IV cyclophosphamide was started and lasted for 5 days a week after being discharged, he was readmitted with a history of vomiting and listlessness. Exam showed a thin, dehydrated child with a bedsore over the sacrum, moderate neck stiffness, paralysis of the third, fourighth, sixth, and seventh cranial nerves, and a flaccid paraplegia of both legs. At lumbar puncture, the pressure was raised and his csf was found to contain viable burkitt tumor cells in large numbers, x-ray exam of the spine showed a small paravertebral mass in the lower thoracic region. He was again treated with IV cyclophosphamide for 10 days without any change in his clinical condition. He died on 5 december. Necropsy showed only scars of healed lesions in the maxilla and renal corightex. Viable tumor was present within the meninges and involved the cranial nerves at the base of the skull; histology showed only a burkitt-cell "meningitis and encephalitis"
Remission Characteristics
The next day after the transfusion, he looked much improved, though he still had a temperature of 102f. The patient's general condition remained satisfactory, but his temperature continued to swing until 12 september when it settled. On 12 september, it was noticed that the jaw tumor wasregressing fairly rapidly. The next day, the serum uric acid had risen to 9.6mg/100ml there was a complete regression of the recurrent left cheek tumor after IV cyclophasphamide. He was discharged on 29 october in reasonable health but had lost about 4lbs.
Treatment & Mechanisms
Proposed Remission Mechanisms
Immune plasma may have had a specific anti-tumor factor missing from control plasma immunological causes for regression passively transfused immunity
Clinical Treatment
Plasma transfusion whole blood transfusion IV cyclophosphamide
Non-Clinical Treatment
None reported