Colon carcinoma in the adolescent

Abstract

Carcinoma of the colon in the adolescent, although an uncommon disease, is usually virulent and has a poorer prognosis than in older patients. We report three cases of colon cancer in youngsters less than 19 years old. Two of them, who were diagnosed and treated early, are presently considered cured; the third died 3 months after surgery. All underwent surgery and adjuvant therapy. In an extensive review of the literature, we found a consensus as to the rarity, virulence and poor prognosis of colon cancer in the younger population. The commonest histological pattern is an aggressive, mucin-producing adenocarcinoma. Predisposing conditions include familial polyposis coli and ulcerative colitis. We also found that a low socioeconomic status could be a predisposing factor. Survival obviously depends on the extent of the disease at diagnosis, and the shorter the delay in diagnosis, the better the prognosis. The therapeutic approach must be aggresive in both surgery and adjuvant therapy; the goal must be early diagnosis, the reward being a possibility of cure, as seen in two of our three cases.

Colon Mucinous Adenocarcinoma in Childhood: A Case Report with Emphasis on Image Findings

“…The literature is not clear about the tumor distribution in the colon; however, the disease does not appear to have a predisposition for any particular portion of the colon [1–4]. In this case, the lesion was in the right colon.…”

Colonic cancer in adolescents. A report of three cases

“…Sebbag et al did not consider heredity to be involved in the pathogenesis of colon cancer. 13 More recently though a known genetic link was described in first degree biological family members of persons with colon cancer. 3 They have 3 times greater risk of developing colon cancer than the general population.…”

“…17 Of the 1,250 cases seen by Sebbag et al over a 25-year period, only 3 (0.24%) were under 19 years. 13 It is said that when colorectal cancer is found in a young person, pre-existing ulcerative colitis or one of the polyposis syndromes must be suspected. 8 None of our cases had any of these.…”

“…The surgical resection must be as radical as feasible for growth. 13 Both systemic and loco-regional chemotherapy, such as intra-hepatic, intra-arterial for liver metastasis, have a role. 7 Where technically feasible, resection of metastatic deposits in the lungs or liver is advisable.…”

“…As Sebbag et al put it, the distribution pattern of colorectal carcinoma appears to have changed. 13 There is no point waiting until older age to check for risks.…”