Pediatric carcinoma of rectum--Varanasi experience

Adenocarcinoma of the colon in children with LAL: A case report

INTRODUCTION

Colorectal cancer in children and adolescents is an exceptional condition. Its clinical symptoms are non-specific, leading to delayed diagnosis and poor prognosis.

CASE PRESENTATION

The present article reports the case of a 15-year-old child followed for acute lymphoblastic leukemia with a history of a grandfather operated on and followed for colorectal cancer. The child was admitted to our department with an occlusive syndrome. Endoscopy and radiological findings suggested the diagnosis of colon adenocarcinoma (AC). The therapeutic decision was a segmental colectomy covering the right colonic angle and colostomy followed by chemotherapy.

DISCUSSION

Colorectal cancer remains an exceptional pathology in children. They often include abdominal pain, nausea, vomiting and rectal discharge. Endoscopy is the key diagnostic test, enabling both distal and proximal lesions to be detected. Primary CA of the colon is rare in children, and even rarer as a second malignancy.

CONCLUSION

The clinical symptoms of colorectal adenocarcinoma in children are non-specific. These cancers are little-known in pediatrics, and are often diagnosed at an advanced stage.

Ameliorative effect of fluvoxamine against colon carcinogenesis via COX-2 blockade with oxidative and metabolic stress reduction at the cellular, molecular and metabolic levels

Fluvoxamine's (FLX's) anticancer potential was investigated in pre-clinical research utilizing a DMH-induced colorectal cancer (CRC) rat model. qRT-PCR and immunoblotting validated the mechanistic investigation. The CRC condition was induced in response to COX-2 and IL-6, however, following FLX therapy, the condition returned to normal. FLX's anti-CRC potential may be attributable to COX-2 inhibition since this molecular activity was more apparent for COX-2 than IL-6. FLX repaired the altered metabolites linked to CRC rats, according to ¹H-NMR analysis. FLX was shown to be similar to 5-FU in terms of tumor protection, which may be useful in future medication development.

Advanced mucinous colorectal carcinoma in a 14-year old male child: A case report and review of the literature

•

Colorectal carcinoma in children is extremely rare and it carries poor prognosis.

•

Diagnosis of this malignancy in children usually is done at advanced stages.

•

Mucinous variant is the most common histological type of colorectal cancer in children.

•

Screening for colorectal cancer in children helps to diagnose the disease at early stage.

Introduction

ColorectaI carcinoma is extremely rare in children and presents with a poor prognosis.

Presentation of case

The present report describes the case of a 14-year old male child who presented with complaints of general weakness and recurrent abdominal pain, caused by a mucinous adenocarcinoma of the transverse colon (Dukes stage which was inoperable.

Discussion

Mucinous histopathological type is the most common type with increased ability to invade the adjacent stromal tissue. This biological behaviour has been reported to be attributable to its aggressive behaviour. Additionally, delay of diagnosis of colorectal carcinoma in children accounts for the advanced disease at diagnosis.

Conclusion

Colorectal carcinoma occurring in both children and adolescents usually have poor prognosis because of not having specific symptoms which contributes to delay of diagnosis. Mimicking of its symptoms with other non-malignant conditions such as intestinal obstruction and acute appendicitis also has been found to contribute to delay of diagnosis as it was in our present case.

An Unusual Presentation of Rectal Carcinoma in a Child

Colorectal carcinoma is a well-known malignancy in adults. However, it is rare in children. Besides, it also has different behaviour in paediatric age-group and usually presents with non-specific symptoms like abdominal pain, weight loss, and anaemia. This usually leads to delay in diagnosis. Adenocarcinoma in children has unfavourable tumour histology (mucinous subtype) and advanced disease stage at presentation which lead to poorer prognosis in children. Family history, genetic typing and sibling screening are essential components of management as this malignancy is frequently seen associated with hereditary syndromes. We describe a case of unusual presentation of rectal carcinoma in a 12-year-old girl.

Immature enteric ganglion cells were observed in a 13-year-old colon signet ring cell carcinoma patient: A case report and literature review

RATIONALE

All the enteric ganglion cells are fully mature by 2 to 5 years of age in human. No one had reported the presentation of immature enteric ganglion cells in elder ones. Colorectal carcinoma is also rare in the adolescent population. The coincidence of these 2 rare events in a 13-year-old boy has never been reported elsewhere, which may suggest some linkage between them.

PATIENT CONCERN

A 13-year-old boy presented with progressive abdominal pain and melena for 3 months. Computed tomography (CT) scan and endoscopic ultrasonography showed significant abnormality in the transverse colon characteristic of marked mural thickening. The biopsy results indicated signet ring cell carcinoma.

DIAGNOSES

A 13-year-old male patient with advanced colon signet ring cell carcinoma. In addition, immature but not mature ganglion cells could be observed in almost all of the slices of the resected nontumorous area of the specimen.

INTERVENTIONS

The transverse colon tumor was resected and the subsequent histopathological examination confirmed the diagnosis of primary colon signet ring cell carcinoma. Then the patient received adjuvant chemotherapy and biological target therapies subsequently.

OUTCOMES

After 6 cycles of adjuvant chemotherapy and biological target therapies, metastasis was however detected within a year.

LESSONS

In this case, a 13-year-old male patient with advanced colon signet ring cell carcinoma were presented. Unexpectedly, immature ganglion cells could be observed in almost all of the slices of the resected nontumorous area of the specimen. It is critical to raise medical awareness and improve the diagnosis and treatment of the signet ring cell carcinoma. This malignancy and the immature ganglion cells may be associated, possibly caused by some unidentified genetic defects. Genome sequencing, histopathological examination, and long-term follow-up of young patients with related diseases, would help further reveal the potential relationship between tumorigenesis and ganglion cells' immaturity, contributing to understanding the molecular mechanisms.

Colorectal carcinoma in the first decade of life: a systematic review

PURPOSE

The aim of this study is to better understand the main aspects related to colorectal carcinoma diagnosed in the first 10 years of life, through a systematic review.

METHODS

We carried out a bibliographic search in PubMed and LILACS, focusing on identifying publications or case reports about colorectal carcinoma in the first 10 years of life. The bibliographical analysis was made in two steps. During the first phase, we excluded those articles whose titles or abstracts did not correspond with the objective settled. Publications without abstract were also included in this phase. During the second phase, we look at the articles and evaluated their content, selecting the cases with colorectal cancer under 10 years old.

RESULTS

From 3880 publications, 132 were selected in the first phase and 84 were evaluated in the second phase. Based on these conditions, 33 articles have cases presented which 4 articles were case reviews and 29 were case reports. Duplicated cases were excluded from the analysis. Fifty-nine cases were described in English and Latin literature. There is an apparent similar proportion between the sexes, and the mean age was 8.6 years old. The main localization was the rectum and sigmoid (45.8 %). Pathologic findings showed that 86.4 % were adenocarcinoma. These tumors are frequently advanced at diagnosis. The Kaplan-Meier 60-month overall survival was 15.3 %. Dukes classification represents a factor related to survival (p = 0.03).

CONCLUSIONS

In children, colorectal carcinoma presents distinctive characteristics, which determines poor survival.

Bone metastasis from colon carcinoma in an 11-year-old boy: radiological features and brief review of the literature

We report the case of an 11-year-old boy who came to our observation with localized pain in the left arm for nearly 5 months. No previous history of trauma was referred in an otherwise healthy patient. Radiographs, isotope bone-scan, computed tomography, and magnetic resonance imaging of the lesion involving the left humerus are discussed. Histological diagnosis from biopsy of the humerus was metastasis from mucinous adenocarcinoma. The primary tumor site was identified in the sigmoid-descending colon, and at presentation, in addition to the left humerus, the disease had already developed in multiple skeletal sites. This report also considers literature concerning such a rare disease in children. This is, to our knowledge, the first report of childhood colorectal cancer diagnosed because of a bone metastasis.

Metastatic Primary Signet Ring Cell Carcinoma of Rectum: A Case Report of 10-Year-old Male Child

Signet ring cell carcinomas of the colon and rectum are well documented in the adult population, but the incidence is very low in the paediatric population. Signet ring cell carcinoma has more malignant potential, mostly present as advanced stage and carries very poor prognosis. We are describing a 10-year-old male patient who presented with acute intestinal obstruction; radiology revealed large bowel obstruction and was diagnosed metastatic primary signet ring cell carcinoma of rectum on biopsy. We have discussed the diagnostic work-up and the management of this rare entity. Due to the high mortality that can be caused by a delay in making the correct diagnosis, signet ring cell carcinoma of colorectum represents a special diagnostic and surgical challenge.