BACKGROUND: Colorectal cancer is exceedingly rare in children and adolescents. Reports from small series indicate that poor prognostic factors are more common in children than in adults, resulting in worse outcome for the pediatric population. METHODS: The Surveillance, Epidemiology, and End Results database was searched for records of children/adolescents with colorectal cancer, and the features and outcomes were compared with those of adults. RESULTS: From January 1973 through December 2005, only 159 children/adolescents (ages 4-20 years) were reported with a diagnosis of colorectal cancer. The most common sites of involvement were the rectum (27%) and the transverse colon (26%). Adenocarcinoma was the most common histiotype in both adults and pediatric patients; however, children/adolescents had more unfavorable histiotypes (ie, mucinous adenocarcinoma [22%] and signet ring cell carcinoma [18%]) when compared with adults (10% and 1%, respectively; P < .001). Poorly differentiated and undifferentiated tumors (grades III and IV, respectively) and distant stage were more common in children/adolescents (P < .001). The 5-year relative survival estimates in children/adolescents and adults were 40% AE 4.2% and 60% AE 0.10%, respectively, confirming a worse outcome in the pediatric age group (P < .001). CONCLUSIONS: Children/adolescents represent a minority of patients with colorectal cancer and have high-risk features and worse outcome than adults. The small number of patients in this age group was an impediment to the development of meaningful clinical trials. Thus, the principles of management for adult colorectal cancer should be used in the treatment of children and adolescents. Cancer 2010;116:758-65.

BackgroundColorectal cancer (CRC) is the first most common cancer in males and the third most common cancer in females in Saudi Arabia. Dietary habits are strongly associated with the inhibition or proliferation of malignancy. Therefore, this study is aiming to investigate the risks and protective benefits of dietary factors affecting CRC in the Mecca region of Saudi Arabia.MethodsA case-control study was conducted from June 2014 to March 2015. One hundred thirty-seven patients with colon and/or rectal cancer were recruited in the case group, while 164 healthy participants were recruited in the control group. A questionnaire was completed with the help of trained dietitians to study the effects of several dietary patterns on the risk of CRC.ResultsDairy product intake of 1–5 servings/day, legume intake of 3–5 servings/week, leafy vegetables intake of 1–5 servings/week, olive oil intake of 1–5 servings/week, black tea intake of three or more cups/day, and coffee intake of one or more cups/day was found to decrease the risk of CRC in participants.ConclusionThis study highlights the importance of changing dietary habits to decrease CRC incidence in the Mecca region.

Thymic carcinoma arising within a thymolipoma has not been reported previously. The authors present a unique case of thymoma and undifferentiated thymic carcinoma arising within a thymolipoma in a 36-year-old woman. The bulk of the resected mass was composed of benign fatty tissue admixed with foci of unremarkable thymic tissue; however, it also harbored a central solid mass showing undifferentiated thymic carcinoma associated with a type B2 thymoma. The carcinoma cells were positive for cytokeratin AE1/AE3, cytokeratin 19, and cytokeratin 8/18. They were negative for vimentin, cytokeratin 7, cytokeratin 20, CD5, epithelial membrane antigen, CD30, placental alkaline phosphatase, carcinoembryonic antigen, CD99, leukocyte common antigen, Epstein-Barr virus, inhibin alpha, and protein gene product 9.5. Rare tumor cells showed positive staining for chromogranin and synaptophysin.

In a phase II trial, 36 patients with advanced gastrointestinal cancer were treated with: folinic acid (FA) 500 mg/m2 in a 2-hr intravenous (IV) infusion, 5- fluorouracil (5-FU) 600 mg/m2 as an IV push injection 1 hr after FA, and hydroxyurea (HU) 35 mg/kg/day given p.o. in three administrations (every 8 hr) 6 hr after 5-FU. Cycles consisted of six weekly treatments for 6 weeks, followed by a 2-week rest period. Thirty-three patients were evaluable for response and 36 for toxicity; 73% had previous chemotherapy. The response rate was 30% (CR + PR), the median duration of response was 21 weeks (range 5-36), and time to failure was 17 weeks (range 3-51). The response in patients previously exposed to chemotherapy was 29% and 44% in chemotherapy-naïve patients. The median survival for all entered patients was 28 weeks (range 6-54). The most common toxicity was gastrointestinal: diarrhea 22/36 (61%), mucositis 15/36 (42%), and nausea and vomiting 15/36 (42%); hematological toxicity was mild. We conclude that HU can potentiate the activity of 5-FU plus FA in advanced gastrointestinal cancer; in particular, HU can restore the activity of 5-FU in patients previously exposed to chemotherapy.