Burkitt’s Lymphoma (BL) is one of the most common paediatric cancers in Sub-Saharan Africa. It is a high-grade lymphoma associated with Epstein Barr Virus (EBV) and malaria infections as co-factors. It may occur as an abdominal tumour with ovarian involvement in a few cases. Previous incidences range between 0.5% to 1.5% of all ovarian neoplasm and are involved in 19% of all adnexal lymphomas. Its occurrence is often among those aged between 6-62 years but very rare among four-year-old girls. This study describes a case of ovarian BL in a four-year-old girl presenting with difficulty in breathing, abdominal pain and distension. The lymphoma had spread to several sites within a short duration. This case represents a great challenge in paediatric oncology management as to when medical or surgical treatment should be considered. Significant laboratory findings were elevated serum Cancer Antigen (CA) 125 and Lactate Dehydrogenase (LDH). Furthermore, flow cytometry, histopathology and immunohistochemistry were confirmed as BL. The child completed chemotherapy and is on remission. Despite its rarity in children, this tumour should be treated aggressively to improve long-term survival.
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