A rapidly growing lymphoma and tumor lysis syndrome in a toddler

A segmental ileal resection was necessary to remove the necrotic bowel. Because the surgeon anticipated that the severity of the chemotherapy would put a small-bowel anastomosis at risk for leakage and fi stula, he proceeded with a right lower quadrant ileostomy and formation of a blind pouch with the remaining colon (Hartmann's procedure). A recent international clinical trial demonstrated that doses of cyclophosphamide and doxorubicin could be reduced without altering effi cacy and survival in intermediate-risk NHL. 2 Newer agents, such as rituximab, a monoclonal antibody that targets the CD20 antigen found in high levels on Burkitt's lymphoma cells, may prove to be effective adjuvant therapies with minimal side effects. 5 Conclusion Burkitt's lymphoma is a rare childhood tumor with a doubling time of 24 hours.