The central idea of ELYNS is to make the scholarly
literature and scientific wisdom free and open to the
scientific as well as the common world.

Does Bodily Temperature Explain the Differential Incidence of Gonadal Burkitt Tumor?

Published Date: December 27, 2016

Does Bodily Temperature Explain the Differential Incidence of Gonadal Burkitt Tumor?

Wilson IB Onuigbo

Medical Foundation & Clinic, 8 Nsukka Lane, Enugu 400001, Nigeria

Corresponding author: Wilson IB Onuigbo, Medical Foundation & Clinic, 8 Nsukka Lane, Enugu 400001, Nigeria, E-mail:

Citation: Onuigbo WIB (2016) Does Bodily Temperature Explain the Differential Incidence of Gonadal Burkitt Tumor?. Arc Cas Rep CMed 3(1): 134.




Whereas the ovary lies within the warm depth of the pelvis, its homologous counterpart, the testis, hangs coolly outside on account of the natural function of the cremaster muscles of the scrotum. Therefore, it is epidemiologically unique that 18 cases of ovarian Burkitt tumor were found against one testicular case in a 30-year biopsy series obtained among a Nigerian ethnic group. Accordingly, it is suggested that temperature is at play. Moreover, this hypothesis should be put to the test along the Burkitt belt worldwide, seeing that the environment itself came into the picture when Burkitt wrote his epochal article in 1958.

Keywords: Burkitt; Tumor; Gonad; Ovary; Testis; Temperature



Although the ovary and the testis are homologous reproductive members of the human body, the one lies within the warm depths of the pelvis while the other hangs coolly outside. This is due to the natural temperature regulation which is a favorable function of the scrotal muscles [1].  Does this snug site confer any advantage in disease? In particular, consider the Burkitt lymphoma with reference to these two organs of reproduction. Interestingly, I was able to publish on both of them in relation to tuberculosis [2]. The same applied to jaw tumors in which Burkitt’s tumor is known to feature, revealing male: female ratio as 6:1 [3]. Therefore, a series containing both testis and ovary was obtained and analyzed. This is in keeping with the experience of a UK group [4] that establishing a histopathology data pool facilitates epidemiological analysis. Therefore, the present paper concerns the findings on the ovary and testis with special reference to Burkitt’s lymphoma.

Top ↑



In my capacity as the sole pathologist based at a Reference Pathology Laboratory serving the Ibos [5], a populous ethnic group in Nigeria, West Africa, I was in a good position to publish on both the testis and the ovary as regards Burkitt’s lymphoma.

Analytical study was carried out between 1970 and 2000. It revealed a total of 134 cases. Surprisingly there was, but one case of it is in the testis against 18 ovarian such tumors (figure 1) which shows the basic diagnostic starry-sky appearance. Therefore, it became necessary to develop a hypothesis for its explanation, especially as important principles of science may be discovered.

Figure 1: Burkitt lymphoma showing the characteristic starry-sky appearance of pale components set in the background of dark lymphoid tumor cells.

 Top ↑



Since there were many ovarian cases as opposed to the single testicular case, it seems to me that nature has provided in this way data which are exploitable. In this context, it is well to remember Julius Cohnheim [6], a famous German pathologist, who said that autopsy findings “are all in a manner experiments instituted by nature, which we need only rightly interpret to get a clear idea of the causes, laws of growth, and significance of the tumors”. It is important to extend this concept in order to cover surgical biopsies; those are utilized in this paper.

It is necessary to put that the present material in focus with already published data. In particular, Burkitt himself paved the way as reported by Magrath [7], namely, that by his inherited observational skills, he was able “to map the distribution of the African lymphoma”. The map of Africa shows the “lymphoma belt” in which Burkitt lymphoma occurs at high incidence. Furthermore, as Orem and his group surmised [8], the geographical variation of the illness was that “the association between humidity, latitude and heat factors linked to the endemicity of malaria and Burkitt’s lymphoma.”

Heat has appeared here. Is it of relevance here? Clearly, the seeming reluctance to invade the testis contrasts with the ovarian predilection. It is hypothesized, that the difference is probably not one of structure but of site with reference to temperature. Accordingly, this odd pattern is open to research worldwide.

Hitherto, in African epidemiologic studies [9], jaw tumors had gained notoriety. Is biopsy preference at work? Specifically, is orchidectomy operation resisted by the families or by the patients themselves? No! My contemporaneous work [10] published in 1977 dealt with 21 testicular samples of which 5 were incisional biopsies and 16 were orchidectomies. Accordingly, my data is probably representative.

It may be added that my experience of testicular diseases covered 12 hospitals utilized by 16 doctors. Curiously, apart from the expected infarction of this organ, odd findings were single instances of associated cholesterol clefts in the epididymis as well as a microabscess. In other words, my epidemiological data pool is capable of demonstrating anything which is unusual.

Eight single ovarian cases were obtained [11-19] in the literature, as contrasted by 2 males in one paper [20] and a single male elsewhere [21]. I was not able to get epidemiologic data from all over the world with reference to gender differences. Moreover, during the period of this study, histologic subtypes were not recognized.

Top ↑



Had testicular Burkitt lymphoma been common in the community, the present series have demonstrated it. Accordingly, it is hypothesized that patterns should be delineated in other areas of the Burkitt belt in Nigeria [22], India [23], and elsewhere. Such data will, in all probability, confirm or confute the role of temperature in this gonadal disease. It is hoped that this finding may pave the way to some advance in both andrology and gynecology.

Top ↑



  1. Romanes GJ.  Cunningham’s Textbook of Anatomy. Oxford University Press, Oxford 1981.
  2. Onuigbo WI. Genital tuberculosis and reproductive function. J Reprod Med. 1978;21(4):249-50..
  3. Onuigbo WI. Jaw tumours in Nigerian Igbos. Br J Oral Surg. 1978;15(3):223-6.
  4. Macartney JC, Rollaston TP, Codling BW. Use of a histopathology data pool for epidemiological analysis. J Clin Pathol. 1980;33(4):351-5.
  5. Basden GT.  Niger Ibos. Cass, London 1966.
  6. Cohnheim J. Lectures on general pathology. Section 1. London: The New Sydenham Society, 1889, p.14.
  7. Magrath I. Denis Burkitt and African lymphoma. Ecancer. 3:159. DOI: 10.3332/ecancer.2009.159
  8. Orem J, Mbidde EK, Lambert B, de Saniose S, Weiderpuss E. Burkitt`s lymphoma in Africa, a review of the epidemiology and etiology. Afr Health Sci. 2007;7(3):166-75.
  9. Anonymous. Cancer in Africa.  Epidemiology and prevention, IARC Press, Lyon 2003.
  10. Onuigbo WI.  Relevance of race in management of testicular tumors. Br Med J. 1977;1(6052):22-3.
  11. Mondal SK, Bera H, Mondal S, Samanta TK. Primary bilateral ovarian Burkitt’s lymphoma in a six-year-old child: Report of a rare malignancy. J Cancer Res Ther. 2014;10(3):755-7. doi: 10.4103/0973-1482.136026.
  12. Aditit G, Harshad A, Sharad A, Amarjeet S. Bilateral ovarian primary Burkitt’s lymphoma in a child: A clinic-radio-pathological evaluation. Med J Dr. D.Y. Patil University. 2015;8(2):223-226.
  13. Lu SC, Shen WL, Cheng YM, Chou CY, Kuo PL. Burkitt’s lymphoma mimicking a primary gynecologic tumor. Taiwan J Obstet Gynecol. 2006;45(2):162-6.
  14. Muñoz Martín AJ1, Pérez Fernández R, Viñuela Beneítez MC, Martínez Marín V, Marquéz-Rodas I, Sabin Domínguez P, et al. Primary ovarian Burkitt lymphoma. Clin Trans Oncol. 2008;10(10):673-675.
  15. Shacham-Abulafia S, Nagar R, Eitan R, Levavi H, Sabah G, Vidal L, et al. Burkitt’s lymphoma of the ovary: Case report and review of the literature. Acta Haematol. 2013;129(3):169-74. doi: 10.1159/000345248.
  16. Onimoe GI, Kahwash S, Termuhlen A, Gross TG, Varga E, Rose MJ. Bilateral Burkitt lymphoma of the ovaries: A report of a case in a child with Williams Syndrome. Case Rep Med. 2011;2011:327263. doi: 10.1155/2011/327263.
  17. Manganaro L, Bernardo S, Sergi ME, Sollazzo P, Vinci V, De Grazia A, et al. Burkitt’s lymphoma presented as advanced ovarian cancer without evidence of lymphadenopathy: CT and MRI findings. Case Rep Radiol. 2013;2013:940160. doi: 10.1155/2013/940160.
  18. Bianchi P, Torcia F, Vitali M, Cozza G, Matteoli M, Giovanale V. An atypical presentation of sporadic ovarian Burkitt’s lymphoma: case report and review of the literature. J Ovarian Res. 2013;6(1):46. doi: 10.1186/1757-2215-6-46.
  19. Weekes LR. Burkitt’s lymphoma of the ovaries. J Natl Med Assoc. 1986;78(7):609-12.
  20. Root M, Wang TY, Hescock H, Parker M, Hudson P, Balducci L. Burkitt’s lymphoma of the testicle: report of 2 cases occurring in elderly patients. J Urol. 1990;144(5):1239-41.
  21. Köksal Y, Yalçin B, Uner A, Akyüz C, Han U, Büyükpamukçu M. Primary testicular Burkitt lymphoma in a child. Pediatr Hematol Oncol. 2005;22(8):705-9.
  22. Bassey I, Ekanem, I, Jombo G, Asana U, Jibrin P. Histoplasmosis masquerading as a Burkitt tumor and challenges in diagnosis: A case finding at University Of Calabar Teaching Hospital, South-South Nigeria. Internet J Ophthalmol Visual Science. 2009;7(1).
  23. Patill K, Mahima VG, Jayanth BS, Ambika L. Burkitt's lymphoma in an Indian girl: a case report. J Indian Soc Pedod Prev Dent. 2007;25(4):194-9.

 Top ↑

Copyright: © 2016 Onuigbo WIB. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.