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Bigliardi R, Morici M, Messere G, Ortiz G, Fernandez J, Varela A, Vidal J, Diaz F, Salas J, Riccheri MC. Colorectal adenocarcinoma in children and adolescents. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2024:S2255-534X(24)00077-X. [PMID: 39353787 DOI: 10.1016/j.rgmxen.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/09/2024] [Indexed: 10/04/2024]
Abstract
INTRODUCTION Colorectal adenocarcinoma is rare in children and adolescents and tends to present with nonspecific signs and symptoms, leading to late diagnoses. OBJECTIVES Our aim was to describe the clinical presentation and progression in children and adolescents with colorectal adenocarcinoma treated at our hospital and detect possible predisposing conditions of this disease. MATERIALS AND METHODS Eight patients with colorectal adenocarcinoma were followed at the Hospital Posadas within the time frame of January 2000 and December 2021. We searched for diseases predisposing to this cancer. RESULTS The mean patient age was 16 years (between 11 and 17 years of age). Clinical presentation was abdominal pain in the 8 patients; 4 of them had pain in the right hypochondrium, 3 had abdominal tumor, 4 had rectal bleeding, and 3 had weight loss. Mean symptom duration was 9 weeks (range: 1-24 weeks). None of the patients showed predisposing illnesses. One patient presented with polyposis, with no cases in any other family member. Histology showed mucinous adenocarcinoma in all the patients, 4 of whom had the signet ring cell subtype. The primary tumor was located in the right colon in 6 patients. At diagnosis, staging according to the modified Dukes classification was: I: one patient; IIb: one patient; IIIb: one patient; IIIc: one patient; and IV: 4 patients. All patients except 2 received chemotherapy and one patient received radiotherapy. Overall survival at 3 years was 25%. CONCLUSIONS All patients presented with mucinous adenocarcinoma, no predisposing diseases were found, and the children with colorectal cancer had a very poor prognosis. Colorectal cancer diagnosis should be considered in children presenting with acute abdominal pain, abdominal tumor, or lower gastrointestinal bleeding, especially if there is weight loss.
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Affiliation(s)
- R Bigliardi
- Servicio de Gastroenterología Pediátrica, Hospital Nacional Prof. A. Posadas, Buenos Aires, Argentina.
| | - M Morici
- Servicio de Hematooncología Pediátrica, Hospital Nacional Prof. A. Posadas, Buenos Aires, Argentina
| | - G Messere
- Servicio de Gastroenterología Pediátrica, Hospital Nacional Prof. A. Posadas, Buenos Aires, Argentina
| | - G Ortiz
- Servicio de Gastroenterología Pediátrica, Hospital Nacional Prof. A. Posadas, Buenos Aires, Argentina
| | - J Fernandez
- Servicio de Gastroenterología Pediátrica, Hospital Nacional Prof. A. Posadas, Buenos Aires, Argentina
| | - A Varela
- Servicio de Gastroenterología Pediátrica, Hospital Nacional Prof. A. Posadas, Buenos Aires, Argentina
| | - J Vidal
- Servicio de Gastroenterología Pediátrica, Hospital Nacional Prof. A. Posadas, Buenos Aires, Argentina
| | - F Diaz
- Servicio de Cirugía Infantil, Hospital Nacional Prof. A. Posadas, Buenos Aires, Argentina
| | - J Salas
- Servicio de Anatomía Patológica, Hospital Nacional Prof. A. Posadas, Buenos Aires, Argentina
| | - M C Riccheri
- Servicio de Hematooncología Pediátrica, Hospital Nacional Prof. A. Posadas, Buenos Aires, Argentina
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Abbaoui S, Zaari N, Ammor A, Benhaddou H. Adenocarcinoma of the colon in children with LAL: A case report. Int J Surg Case Rep 2024; 121:109995. [PMID: 38971032 PMCID: PMC11269919 DOI: 10.1016/j.ijscr.2024.109995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/27/2024] [Accepted: 07/02/2024] [Indexed: 07/08/2024] Open
Abstract
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.
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Affiliation(s)
- Siham Abbaoui
- Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco.
| | - Najlae Zaari
- Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Abdelouhab Ammor
- Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Houssain Benhaddou
- Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco
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Bergamaschi L, Chiaravalli S, Signoroni S, Di Bartolomeo M, Ferrari A. Management and pharmacotherapy of pediatric colorectal carcinoma: a review. Expert Opin Pharmacother 2023; 24:1527-1535. [PMID: 37358925 DOI: 10.1080/14656566.2023.2230123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Colorectal carcinoma (CRC) is one of the most common tumors in adult, but is extremely rare in children. In childhood, CRC often presents unfavorable aggressive histotypes, advanced clinical stage at onset and a worse prognosis. Pediatric CRC series are limited and include few patients, therefore information about treatment strategy and pharmacotherapy is scarce. For this reason, management of these patients represents a real challenge for pediatric oncologists. AREAS COVERED The authors provide an overview of the general features and management strategies of pediatric CRC with specific attention to systemic treatment. Literature data regarding pharmacotherapy in published pediatric series are summarized and analyzed in detail, according to adult treatment standards. EXPERT OPINION In the absence of specific recommendations for pediatric CRC, the general therapeutic strategy should follow the same principles as for adults and should be the result of a multidisciplinary discussion. Patient access to optimal treatment is difficult due to the lack of new drugs approved for the pediatric age group and non-availability of clinical trials. Collaboration between pediatric and adult oncologists is considered crucial in order to overcome these issues and find solutions to increase knowledge and improve the outcome of such a rare disease in children.
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Affiliation(s)
- Luca Bergamaschi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Stefano Signoroni
- Unit of Hereditary Digestive Tract Tumors, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Maria Di Bartolomeo
- Gastrointestinal Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
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4
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Özcan HN, Yavuz ÖÖ, Ekinci S, Oguz B, Kutluk T, Haliloglu M. Imaging findings of gastrointestinal tract tumors in children and adolescents. Insights Imaging 2022; 13:51. [PMID: 35316432 PMCID: PMC8941063 DOI: 10.1186/s13244-022-01193-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/19/2022] [Indexed: 12/04/2022] Open
Abstract
Gastrointestinal (GI) tract tumors are rarely seen in children and adolescents, and can easily be misdiagnosed. Lymphoma is the most frequent GI tract tumor, and the common locations are ileum and ileocecal area. GI tract tumors may present as large heterogeneous mass lesions. For gastric and colonic tumors, increased wall thickening usually prompts the diagnosis of GI tract tumors. Computed tomography and magnetic resonance imaging might be used in clinically suspected cases for correct/appropriate diagnosis and management. Awareness as regards the most common tumors and their locations is paramount for radiologists. Likewise, the aim of this article was to define the imaging findings of primary benign and malignant GI tract tumors in children and adolescents.
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Affiliation(s)
- H Nursun Özcan
- Department of Radiology/Subdivision of Pediatric Radiology, Hacettepe University School of Medicine Ankara, Sıhhiye, 06100, Ankara, Turkey.
| | - Özlem Özkale Yavuz
- Department of Radiology/Subdivision of Pediatric Radiology, Hacettepe University School of Medicine Ankara, Sıhhiye, 06100, Ankara, Turkey
| | - Saniye Ekinci
- Department of Pediatric Surgery, Hacettepe University School of Medicine Ankara, Sıhhiye, Turkey
| | - Berna Oguz
- Department of Radiology/Subdivision of Pediatric Radiology, Hacettepe University School of Medicine Ankara, Sıhhiye, 06100, Ankara, Turkey
| | - Tezer Kutluk
- Division of Pediatric Oncology, Department of Pediatrics, Hacettepe University School of Medicine Ankara, Sıhhiye, Turkey
| | - Mithat Haliloglu
- Department of Radiology/Subdivision of Pediatric Radiology, Hacettepe University School of Medicine Ankara, Sıhhiye, 06100, Ankara, Turkey
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5
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Aguiar Ferreira A, Basso S, Gomes P, Semedo L. Mucinous colorectal carcinoma in paediatric age: an unusual diagnostic. BMJ Case Rep 2021; 14:e246705. [PMID: 34887296 PMCID: PMC8663069 DOI: 10.1136/bcr-2021-246705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Susana Basso
- Radiology, Coimbra University Hospital Centre, Coimbra, Portugal
| | - Paula Gomes
- Radiology, Coimbra University Hospital Centre, Coimbra, Portugal
| | - Luis Semedo
- Radiology, Coimbra University Hospital Centre, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Thibodeau R, Jafroodifar A, Bakrukov D, Alkukhun L, Mirchia K, Majmudar A, Gupta S, Hanumaiah R. Intussusception secondary to signet ring cell adenocarcinoma in adolescent. Radiol Case Rep 2021; 16:1198-1203. [PMID: 33815641 PMCID: PMC8010575 DOI: 10.1016/j.radcr.2021.02.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 02/07/2023] Open
Abstract
Despite the overall decrease in incidence and mortality rates for older adults, colorectal cancer in young adults is increasing. We present a case of a 15-year-old male who presented with 1.5 weeks of intermittent, sharp, severe right-sided abdominal pain. Abdominal radiograph demonstrated an air-fluid level within the right hemiabdomen. Computed tomography demonstrated marked wall thickening and a mass at the junction of the ascending colon and hepatic flexure causing obliteration of the lumen with a fluid-filled, dilated ascending colon. Follow-up ultrasonography demonstrated a 5.9 × 3.9 cm targetoid lesion in the right upper quadrant concerning for intussusception. Contrast enema revealed failure of contrast filling beyond the hepatic flexure due to a lobulated central filling defect surrounded by a claw-like contrast extension. Pathology of the polypoid lesion revealed poorly differentiated signet ring cell adenocarcinoma of the colon at the hepatic flexure. Despite its rarity, this case elucidates the need to consider colorectal carcinoma in adolescent and young adult patients who present with recurrent abdominal signs and symptoms.
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Affiliation(s)
- Ryan Thibodeau
- Department of Radiology, State University of New York (SUNY) Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Abtin Jafroodifar
- Department of Radiology, State University of New York (SUNY) Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Dmitriy Bakrukov
- Department of Radiology, State University of New York (SUNY) Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Leen Alkukhun
- Department of Radiology, State University of New York (SUNY) Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Kavya Mirchia
- Department of Radiology, State University of New York (SUNY) Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Anand Majmudar
- Department of Radiology, State University of New York (SUNY) Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Saurabh Gupta
- Department of Radiology, State University of New York (SUNY) Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Ravikumar Hanumaiah
- Department of Radiology, State University of New York (SUNY) Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA
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De Pasquale MD, Crocoli A, Caldaro T, Rinelli M, Spinelli GP, Francalanci P, Cozza R, Inserra A, Miele E. Targeting Epidermal Growth Factor Receptor (EGFR) in Pediatric Colorectal Cancer. Cancers (Basel) 2020; 12:E414. [PMID: 32053874 PMCID: PMC7072611 DOI: 10.3390/cancers12020414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/30/2020] [Accepted: 02/04/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Colorectal carcinoma (CRC) is very rare in the pediatric and adolescent age range and clinical management is performed according to adult protocols. We report, for the first time in the literature, a case of a child with metastatic CRC successfully treated with panitumumab associated to chemotherapy. Methods: A twelve-year-old male was diagnosed with CRC with nodal metastasis and peritoneal neoplastic effusion. After performing a genetic evaluation, in light of the absence of mutations in RAS family genes, anti-Epidermal Growth Factor Receptor (EGFR) monoclonal antibody, panitumumab, was added to chemotherapy FOLFOXIRI. Results: The child successfully responded to therapy with normalization of the Carbohydrate Antigen (CA) 19.9 value after the third cycle of treatment. After the sixth cycle, he underwent surgery that consisted in sigmoid resection with complete D3 lymphadenectomy. At histological evaluation, no residual neoplastic cells were detectable in the surgical specimen. He completed 12 cycles of chemotherapy plus panitumomab and he is alive without disease 14 months from diagnosis. Conclusions: Our results suggest performing mutational screening for colorectal cancer also in the pediatric setting, in order to orient treatment that should include targeted therapies.
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Affiliation(s)
- Maria Debora De Pasquale
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.D.D.P.); (R.C.)
| | - Alessandro Crocoli
- Surgical Oncology Unit, Department of Surgery, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (A.C.); (A.I.)
| | - Tamara Caldaro
- Digestive Endoscopy and Surgery Unit, Department of Surgery, Bambino Gesù Children’s Hospital-IRCCS, 00165 Rome, Italy;
| | - Martina Rinelli
- Department of Laboratories, Genetic Unit, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy;
| | - Gian Paolo Spinelli
- Oncology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Via Giustiniano, 04011 Aprilia, Italy;
| | - Paola Francalanci
- Department of Laboratories, Pathology Unit, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy;
| | - Raffaele Cozza
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.D.D.P.); (R.C.)
| | - Alessandro Inserra
- Surgical Oncology Unit, Department of Surgery, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (A.C.); (A.I.)
| | - Evelina Miele
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.D.D.P.); (R.C.)
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8
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Yahaya JJ, Msokwa EK, Mremi A. Mucinous Colorectal Carcinoma in a 17-Year-Old Male: A Diagnosis with Low Clinical Index of Suspicion. Case Rep Pediatr 2019; 2019:6371579. [PMID: 31662935 PMCID: PMC6778923 DOI: 10.1155/2019/6371579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/12/2019] [Indexed: 12/13/2022] Open
Abstract
Colorectal carcinoma (CRC) is commonly found in adults. CRC in the pediatric population is extremely rare. Usually, CRC is diagnosed in children at advanced stage due to a low clinical index of suspicion. Mucinous type of CRC and its signet ring variant are the most common histological types which carry very poor clinical outcomes. This paper reports a 17-year-old male who presented with mild pallor and a 3-month history of abdominal pain accompanied with a mass on the left lower quadrant, and it was then confirmed histologically to be mucinous CRC of signet ring variant. This paper will help to raise awareness among the physicians and pediatricians in including CRC in the preliminary workouts for the purpose of shortening the delay for diagnosis which in turn would compromise the prognosis of the patients.
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Affiliation(s)
- James Joseph Yahaya
- Department of Biomedical Sciences, College of Health Sciences (CHS), The University of Dodoma, Dodoma, Tanzania
| | - Edward Ketson Msokwa
- Department of Surgery, College of Health Sciences (CHS), The University of Dodoma, Dodoma, Tanzania
| | - Alex Mremi
- Department of Pathology, Kilimanjaro Christian Medical Centre (KCMC), Kilimanjaro, Tanzania
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9
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Kaplan MA, Ozaydin S, Yerlikaya H, Karaagac M, Gumus M, Cil T, Yalcintas Arslan Ü, Ozdemir N, Sakin A, Bilici M, Koca D, Uysal M, Dane F, Sever ÖN, Seker MM, Oruc Seker Z, Can MF, Geredeli C, Aksoy A, Pilanci KN, Ozturk Topcu T, Isikdogan A. Clinicopathologic and Prognostic Differences between Three Different Age Groups (Child/Adolescent, Young Adults, and Adults) of Colorectal Cancer Patients: A Multicentre Study. Oncol Res Treat 2019; 42:516-522. [PMID: 31437835 DOI: 10.1159/000502120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/13/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is a rare disease amongst children and adolescents. Previous studies have reported a number of differences between children/adolescents, young adults, and adult patients with CRC. However, none of these studies compared these age groups according to their clinicopathologic and prognostic characteristics. In the current study, we compare these three age groups. METHODS A total of 173 (1.1% of 15,654 patients) young CRC patients (≤25 years) were included in the study. As a control group, 237 adult CRC patients (>25 years) were also included. Patients were divided into three age groups: child/adolescent (10-19 years), young adult (20-25 years), and adult (>25 years). RESULTS Statistical differences amongst the three groups in terms of gender (p = 0.446), family history (p = 0.578), symptoms of presentation (p = 0.306), and interval between initiation of symptoms and diagnosis (p = 0.710) could not be demonstrated. Whilst abdominal pain (p < 0.001) and vomiting (p = 0.002) were less common in young adults than in other groups, rectal bleeding and changes in bowel habits were relatively less common in adolescents than in other groups. Rectal localisation (p = 0.035), mucinous adenocarcinoma (p < 0.001), and a poorly differentiated histologic subtype (p < 0.001) were less common in the adult group than in other groups. The percentage of patients with metastasis and sites of metastasis (e.g., peritoneum and lung) differed between groups. The median overall survival was 32.6 months in the adolescent group, 57.8 months in the young adult group and was not reached in the adult group (p = 0.022). The median event-free survival of the adolescent, young adult, and adult groups was 29.0, 29.9, and 61.6 months, respectively (p = 0.003). CONCLUSIONS CRC patients of different age groups present different clinicopathologic and prognostic characteristics. Clinicians should be aware of and manage the disease according to these differences.
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Affiliation(s)
- Muhammet Ali Kaplan
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakir, Turkey,
| | - Sukru Ozaydin
- Department of Medical Oncology, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Halis Yerlikaya
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Mustafa Karaagac
- Department of Medical Oncology, Konya Numune Training and Research Hospital, Konya, Turkey
| | - Mahmut Gumus
- Department of Medical Oncology, Faculty of Medicine, Medeniyet University, Istanbul, Turkey
| | - Timucin Cil
- Department of Medical Oncology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Ülkü Yalcintas Arslan
- Department of Medical Oncology, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Nuriye Ozdemir
- Department of Medical Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, Okmeydani Education and Research Hospital, Ankara, Turkey
| | - Mehmet Bilici
- Department of Medical Oncology, Atatürk University, Erzurum, Turkey
| | - Dogan Koca
- Department of Medical Oncology, Kocaeli Medikal Park Hospital, Kocaeli, Turkey
| | - Mukremin Uysal
- Department of Medical Oncology, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Faysal Dane
- Department of Medical Oncology, Medical Oncology, Marmara University, Istanbul, Turkey
| | - Özlem Nuray Sever
- Department of Medical Oncology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Mehmet Metin Seker
- Medical Oncology Department, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Zeynep Oruc Seker
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Mehmet Fatih Can
- Department of Medical Oncology, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Caglayan Geredeli
- Department of Medical Oncology, Konya Numune Training and Research Hospital, Konya, Turkey
| | - Asude Aksoy
- Department of Medical Oncology, Faculty of Medicine, Fırat University, Malatya, Turkey
| | | | - Turkan Ozturk Topcu
- Department of Medical Oncology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Abdurrahman Isikdogan
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
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Yang HB, Namgoong JM, Kim KH, Kim DY, Park J, Shin HB, Youn JK, Lee S, Lee JW, Jung SE, Chung JH, Choe YM, Heo TG, Ho IG, Kim HY. Pediatric Adenocarcinoma in Korea: A Multicenter Study. Cancer Res Treat 2019; 52:117-127. [PMID: 31163958 PMCID: PMC6962484 DOI: 10.4143/crt.2019.092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 05/31/2019] [Indexed: 12/18/2022] Open
Abstract
Purpose Adenocarcinoma is an extremely rare malignancy in the pediatric population. Research regarding pediatric adenocarcinoma is very rare in Korea. This study aimed to investigate the clinical features of pediatric adenocarcinomas of various primary organ sites in Korea. Materials and Methods Pediatric patients under 18 years, diagnosed with adenocarcinoma of various sites between January 1995 and December 2016, were included. We retrospectively reviewed patient and tumor characteristics and calculated survival estimates, reported as 5-year survival rate and 95% confidence interval. Results Of 80 patients (median age, 15 years; range, 10 to 17 years), 37 (46.3%) were men, and 24 (30%) had a family history of cancer or underlying disease relevant to malignancy. The cancer locations were the colon and rectum (n=32), ovaries (n=18), stomach (n=15), lung (n=4), small bowel (n=1), and other sites (n=10). Totally, 54.8% patients (42/77) had stage 3 or 4 disease. The median follow-up period was 2.0 years (range, 0 to 20.4). The 5-year overall survival estimate for all patients, and for those with stomach, colorectal, ovarian, and other cancer sites were 57.9%±11.5%, 58.2%±25.7%, 41.5%±18.2%, 87.5%±16.2%, and 64.0%±34.4%, respectively. The 5-year survival rate differed significantly between categories of adenocarcinomas into gastrointestinal (GI) (44.7%) and non-GI adenocarcinomas (78.8%) (p=0.007). The 5-year survival rate also differed significantly according to carcinoembryonic antigen level (69.3% in < 3 ng/mL, 23.8% in > 3 ng/mL; p < 0.001). Conclusion In pediatric patients, adenocarcinomas arise from various organs and are often diagnosed at advanced stages. Large, prospective studies for their accurate clinical characteristics and prognostic factors are needed.
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Affiliation(s)
- Hee-Beom Yang
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea
| | - Jung-Man Namgoong
- Department of Pediatric Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Ki Hoon Kim
- Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Dae Yeon Kim
- Department of Pediatric Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Jinyoung Park
- Department of Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyun Beak Shin
- Department of Surgery, Chonbuk National University School of Medicine, Jeonju, Korea
| | - Joong Kee Youn
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea
| | - Sanghoon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Won Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Eun Jung
- Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hee Chung
- Department of Pediatric Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun-Mee Choe
- Department of Pediatric Surgery, Inha School of Medicine, Incheon, Korea
| | - Tae Gil Heo
- Department of Surgery, Ilsan Paik Hospital, Inje University, Goyang, Korea
| | - In Geol Ho
- Department of Pediatric Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun-Young Kim
- Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Korea
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Indini A, Bisogno G, Cecchetto G, Vitellaro M, Signoroni S, Massimino M, Riccipetitoni G, Zecca M, Dall'Igna P, De Pasquale MD, Inserra A, Chiaravalli S, Basso E, Virgone C, Sorbara S, Di Bartolomeo M, D'Angelo P, Ferrari A. Gastrointestinal tract carcinoma in pediatric and adolescent age: The Italian TREP project experience. Pediatr Blood Cancer 2017; 64. [PMID: 28561949 DOI: 10.1002/pbc.26658] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/03/2017] [Accepted: 05/08/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Gastrointestinal (GI) carcinomas are very rare in the pediatric and adolescent age range. We report the clinical features, treatment, and outcome of a series of children and adolescents with GI carcinoma prospectively registered in the Italian Tumori Rari in Età Pediatrica (TREP) project. METHODS The TREP project developed diagnostic and therapeutic guidelines based on recommendations currently in use for adults. Clinical data were centrally registered and reviewed. RESULTS Fifteen patients were registered over the years 2000-2016. Most of the tumors were colorectal carcinomas (12 cases). All but one patient had advanced-stage disease (American Joint Committee on Cancer stages III-IV), and the majority of patients had aggressive histological subtypes, i.e. poorly differentiated (G3) (five patients), mucinous (four patients), and signet ring (two patients) adenocarcinomas. Surgery was performed in 13 of 15 patients, and was radical in nine of 13 patients. Only one patient received postoperative radiotherapy. All patients received chemotherapy, with the addition of bevacizumab in two cases. Nine patients were still alive at the time of the present report, but two of them had only just completed their treatment program and one patient is still on treatment. Six patients died due to disease progression. CONCLUSIONS This prospective report on pediatric GI tract carcinomas confirms the rarity and biological aggressiveness of these diseases in pediatric and adolescent age. Further prospective studies are needed to explore the distinct biology of tumor in this age group in order to find new therapeutic targeted agents.
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Affiliation(s)
- Alice Indini
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Gianni Bisogno
- Hematology-Oncology Division, Department of Pediatrics, Padova University Hospital, Padova, Italy
| | - Giovanni Cecchetto
- Division of Pediatric Surgery, Department of Pediatrics, Padova University Hospital, Padova, Italy
| | - Marco Vitellaro
- Unit of Hereditary Digestive Tract Tumours, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Colorectal Surgery Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Signoroni
- Unit of Hereditary Digestive Tract Tumours, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maura Massimino
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Marco Zecca
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Patrizia Dall'Igna
- Department of Women's and Children's Health, Pediatric Surgery Unit, Padova University Hospital, Padova, Italy
| | | | - Alessandro Inserra
- Department of Pediatric Surgery, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Stefano Chiaravalli
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Eleonora Basso
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Torino, Italy
| | - Calogero Virgone
- Division of Pediatric Surgery, Department of Pediatrics, Padova University Hospital, Padova, Italy
| | - Silvia Sorbara
- Hematology-Oncology Division, Department of Pediatrics, Padova University Hospital, Padova, Italy
| | - Maria Di Bartolomeo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo D'Angelo
- Pediatric Oncology Unit, G. Di Cristina Children's Hospital, Palermo, Italy
| | - Andrea Ferrari
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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12
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Gonzalez RS, Riddle ND. Syndrome-Associated Tumors by Organ System. J Pediatr Genet 2016; 5:105-15. [PMID: 27617151 PMCID: PMC4918701 DOI: 10.1055/s-0036-1580597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 08/26/2015] [Indexed: 12/20/2022]
Abstract
Certain tumors suggest the possibility of a patient harboring a genetic syndrome, particularly in children. Syndrome-associated tumors of the gastrointestinal tract, genitourinary tract, gynecologic tract, heart, lungs, brain, eye, endocrine organs, and hematopoietic system will be briefly discussed.
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Affiliation(s)
- Raul S. Gonzalez
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, New York, United States
| | - Nicole D. Riddle
- Department of Pathology, Cunningham Pathology LLC, Birmingham, Alabama, United States
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13
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Weber ML, Schneider DT, Offenmüller S, Kaatsch P, Einsiedel HG, Benesch M, Claviez A, Ebinger M, Kramm C, Kratz C, Lawlor J, Leuschner I, Merkel S, Metzler M, Nustede R, Petsch S, Seeger KH, Schlegel PG, Suttorp M, Zolk O, Brecht IB. Pediatric Colorectal Carcinoma is Associated With Excellent Outcome in the Context of Cancer Predisposition Syndromes. Pediatr Blood Cancer 2016; 63:611-7. [PMID: 26575411 DOI: 10.1002/pbc.25839] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 10/15/2015] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Colorectal carcinoma (CRC) is the second most common adult cancer in Germany, however, it is extremely rare in children and adolescents. In these patients, previous literature describes aggressive behavior and diagnosis at advanced stage. METHOD Thirty-one patients with CRC age ≤ 18 years and treated between 1990 and 2012 have been identified through the structures and registries of the German Society for Pediatric Oncology and Hematology. RESULTS The age range was 9-18 years (median 13.5 years); the median follow-up time was 43.9 months (range 1-124 months). Twenty-six patients (84%) were tested for a genetic tumor syndrome (GTS); of these, 11 patients (35% of all patients) tested positive (eight cases of Lynch syndrome, one patient with familial adenomatous polyposis, two patients with constitutional mismatch repair deficiency). An unfavorable histology was reported in 55% of the records (n = 17), a poor differentiation (grade III) in 68% of carcinoma (n = 21). Overall survival (OS) and event-free survival at 5 years was 52.0% and 65.6%, respectively. Five-year survival according to stage was 100% in stage II (n = 2), 100% in stage III (n = 13), and 12.9% in stage IV (n = 15; P < 0.001). Five-year OS in patients with and without a defined GTS was 100% and 36.5% (P = 0.019), respectively. CONCLUSION Children and adolescents with CRC are frequently diagnosed in advanced stages and have an unfavorable prognosis. In this study, a high percentage of pediatric CRC patients presented with a tumor predisposition syndrome and showed an especially favorable OS.
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Affiliation(s)
- Marie L Weber
- Department of Pediatric Hematology and Oncology, University Children's Hospital Erlangen, Germany
| | | | - Sonja Offenmüller
- Department of Pediatric Hematology and Oncology, University Children's Hospital Erlangen, Germany
| | - Peter Kaatsch
- German Childhood Cancer Registry (GCCR), Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Germany
| | - Hagen Graf Einsiedel
- Department of Pediatric Oncology and Hematology, University Children's Hospital Greifswald, Germany
| | - Martin Benesch
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Austria
| | - Alexander Claviez
- Pediatric Hematology and Oncology, University Children's Hospital Kiel, Germany
| | - Martin Ebinger
- Pediatric Hematology and Oncology, University Children's Hospital Tuebingen, Germany
| | - Christof Kramm
- Pediatric Hematology and Oncology, University Children's Hospital Goettingen, Germany
| | - Christian Kratz
- Pediatric Hematology and Oncology, University Children's Hospital Hannover, Germany
| | - Jennifer Lawlor
- Department of Pediatric Hematology and Oncology, University Children's Hospital Erlangen, Germany
| | - Ivo Leuschner
- Department of Paidopathology, University of Kiel, Germany
| | - Susanne Merkel
- Clinical Tumor Registry, Department of Surgery, University of Erlangen, Germany
| | - Markus Metzler
- Department of Pediatric Hematology and Oncology, University Children's Hospital Erlangen, Germany
| | - Rainer Nustede
- Department of Pediatric Surgery, University Children's Hospital Hannover, Germany
| | - Sabine Petsch
- Tumor Registry, University of Erlangen-Nuernberg, Germany
| | - Karl-Heinz Seeger
- Pediatric Oncology and Hematology, Charité University Medicine, Berlin, Germany
| | - Paul-Gerhardt Schlegel
- Department of Pediatric Hematology and Oncology, University Children's Hospital Wuerzburg, Germany
| | - Meinolf Suttorp
- Department of Pediatric Hematology and Oncology, University Children's Hospital Dresden, Germany
| | - Oliver Zolk
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, University of Ulm, Germany
| | - Ines B Brecht
- Department of Pediatric Hematology and Oncology, University Children's Hospital Erlangen, Germany
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14
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Gonzalez L, Alvarez J, Weinstein E, Korenis P. Familial adenomatous polyposis in an adolescent with coexisting schizophrenia: treatment strategies and implications. Mol Genet Genomic Med 2015; 3:391-5. [PMID: 26436104 PMCID: PMC4585446 DOI: 10.1002/mgg3.114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 09/02/2014] [Indexed: 11/28/2022] Open
Abstract
Schizophrenia is associated with high mortality and morbidity. The etiology of schizophrenia remains unclear, studies implicate a multifactorial origin with genetic and environmental factors. The adenomatous polyposis coli (APC) gene has been associated with FAP (familial adenomatous polyposis), and studies have linked it to schizophrenia. However, there are few studies which examine the association between FAP and schizophrenia. Limited data exist regarding recommendations for genetic counseling of adolescents with comorbid psychiatric illness. A case of an adolescent with FAP who developed psychotic symptoms is presented. This case hopes to add to the literature about mental illness in those with FAP. A review of literature about the role of APC in schizophrenia as well as implications of genetic counseling on those who suffer with mental illness will be discussed.
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Affiliation(s)
- Luisa Gonzalez
- Bronx Lebanon Hospital Center, Albert Einstein College of MedicineBronx, New York
- Albert Einstein College of MedicineBronx, New York
| | - Jose Alvarez
- Bronx Lebanon Hospital Center, Albert Einstein College of MedicineBronx, New York
| | | | - Panagiota Korenis
- Bronx Lebanon Hospital Center, Albert Einstein College of MedicineBronx, New York
- Albert Einstein College of MedicineBronx, New York
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15
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Selected case from the Arkadi M. Rywlin International Pathology Slide Club: carcinoma of the transverse colon in a young girl. Adv Anat Pathol 2015; 22:217-24. [PMID: 25844680 DOI: 10.1097/pap.0000000000000068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We report a case of a 14-year-old female with primary adenocarcinoma of the transverse colon. She was hospitalized after presenting with abdominal pain and signs of intestinal obstruction. There was no health antecedent or family history of neoplasia. Physical examination revealed a distended abdomen. Tenderness was elicited to palpation of the right lower quadrant. Magnetic resonance imaging of the abdomen revealed obstructive signs, with a constricting lesion in the mid-transverse colon of probable neoplastic nature. Laparoscopic segmental resection of the colon was followed by standard right hemicolectomy. A circumferential mid-transverse tumor was diagnosed as primary colorectal carcinoma (CRC) of signet-ring cell type, AJCC stage IIIC, Dukes' C stage. On the basis of immunohistochemistry and clinical data, hereditary nonpolyposis and hamartomatous colorectal cancer syndromes were excluded. Involvement of either the p53, BRAF, or K-RAS genes was ruled out by immunohistochemistry profiling and genetic testing. The neoplasm was categorized as sporadic. The possibility of activation of the Wnt signaling pathway was suspected, because of a defective turnover of the β-catenin protein. Postoperatively, the patient was treated with both systemic and intra-abdominal adjuvant chemotherapy, including oxaliplatin. Between 18 and 24 months after diagnosis, intra-abdominal tumor recurrences were detected. The patient underwent bilateral oophorectomies for Krukenberg tumors and received salvage chemotherapy. Recently, additional recurrent metastatic retroperitoneal disease caused hydronephrosis. The retroperitoneal mass was debulked and a ureteric stent was placed. At the time of this writing, 43 months after diagnosis, the patient is receiving FOLFOX chemotherapy combined with panitumumab. CRC of childhood is exceedingly rare, generally develops in the setting of unrecognized genetic predisposing factors to cancer, presents with advanced disease, is high grade, and tends to have dismal prognosis.
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16
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Rahman MAM, Chowdhury TK, Bhuiyan MAH, Al Farooq MA, Sajid MM, Banu T. Colorectal carcinoma in first decade of life: our experience. Pediatr Surg Int 2014; 30:847-51. [PMID: 25005910 DOI: 10.1007/s00383-014-3537-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2014] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Though the lifetime risk of colorectal carcinoma (CRC) in general population is 5-6 %, it is uncommon in pediatric age group. Here, we are reporting our experience of CRC in the first decade of life. METHODS From January 2010 to December 2013, seven patients with histopathologically confirmed colorectal carcinoma were treated in the Department of Pediatric Surgery, Chittagong Medical College and hospital. Age, sex, presenting symptoms, location of the primary tumor, serum CEA level, treatment modalities and outcomes were evaluated. RESULTS There were four male and three female patients and age ranged from 6.5 to 10.5 years. Rectum (3 patients) and rectosigmoid (2 patients) were the most common primary sites. Serum carcinoembryonic antigen level was obtained in six patients and in only one patient the level was raised markedly (137 ng/ml). Two patients of familial adenomatous polyposis had localized disease and others presented in an advanced stage. Histopathologically, poorly differentiated adenocarcinoma was noted in five patients with one signet ring cell type and well differentiated in rest of the two patients. Only one patient was surviving at the last follow up. CONCLUSION Advanced stage at diagnosis, aggressive histologic subtype and poor survival are the hallmarks of pediatric CRC.
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Affiliation(s)
- M A Mushfiqur Rahman
- Department of Pediatric Surgery, Chittagong Medical College and Hospital, Chittagong, Bangladesh
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17
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Ferrari A, Casanova M, Massimino M, Sultan I. Peculiar features and tailored management of adult cancers occurring in pediatric age. Expert Rev Anticancer Ther 2014; 10:1837-51. [DOI: 10.1586/era.10.105] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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18
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Deng W, Sears S, Garand S, Farricielli L. Delayed diagnosis of familial adenomatous polyposis in an adolescent patient with a coexisting eating disorder. BMJ Case Rep 2013; 2013:bcr-2013-200439. [PMID: 24336579 DOI: 10.1136/bcr-2013-200439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Colorectal carcinoma in the population aged less than 20 years of age is rare but associated with poor prognosis, which is attributable to advanced disease at presentation and higher incidence of the unfavourable mucinous histology. Colorectal carcinoma commonly presents with non-specific gastrointestinal symptoms in conjunction with iron deficiency anaemia. Many of these symptoms can mimic eating disorders, which are common in adolescent women. We present the case of a 20-year-old woman with previously undiagnosed familial adenomatous polyposis and colorectal carcinoma who experienced a significant delay in diagnosis, given a coexisting eating disorder mimicking her symptoms. After confirmation of the diagnosis by colonoscopy and genetic testing, the patient underwent a successful proctocolectomy and experienced full recovery. This case is a reminder that underlying organic pathology should always be excluded prior to a diagnosis of an eating disorder.
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Affiliation(s)
- Wu Deng
- University of California, Irvine, USA
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19
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Furman WL, Tricoli JV. Important considerations in treating children, adolescents and young adults with colorectal carcinoma. COLORECTAL CANCER 2013. [DOI: 10.2217/crc.13.40] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
SUMMARY Colorectal carcinoma (CRC) in children, adolescents and young adults under 30 years of age is rare. When it occurs in these young people, is this just an ‘adult’ cancer occurring in a young patient or is it a different disease? How should these patients be managed? Here, we review what is known about the epidemiology and clinical presentation of CRC in children, adolescents and young adults, as well as the current model for CRC development to provide a framework for questioning whether CRC in these young patients is the same disease as that seen in their older adult counterparts. In addition, we will summarize the clinical options described in the peer-reviewed literature to provide a basis for management decisions of these young patients.
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Affiliation(s)
- Wayne L Furman
- Department of Oncology, St Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
- University of Tennessee Department of Pediatrics, TN, USA
| | - James V Tricoli
- Diagnostic Biomarkers and Technology Branch, Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, 9609 Medical Center Drive, 3 West, Room 526, MSC 9728, Bethesda, MD 20892, USA
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20
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Noh SY, Oh SY, Kim SH, Kim HY, Jung SE, Park KW. Fifteen-year-old colon cancer patient with a 10-year history of ulcerative colitis. World J Gastroenterol 2013; 19:2437-2440. [PMID: 23613641 PMCID: PMC3631999 DOI: 10.3748/wjg.v19.i15.2437] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 01/15/2013] [Accepted: 02/06/2013] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel disease (IBD) is regarded as one of the risk factors for colorectal cancer, and early detection of cancer in these patients may be difficult, especially in pediatric patients. Prognosis of pediatric colorectal cancer is known to be poor, because of delayed diagnosis and unfavorable differentiation. We report a case of a pediatric patient with a 10-year history of ulcerative colitis who was diagnosed with sigmoid colon cancer when he was 15 years old. He underwent proctocolectomy with ileal pouch anal anastomosis. Postoperative pathological examination of the tumor revealed adenocarcinoma. The pericolic tissue layer was infiltrated, but metastases were not found in either of the two lymph nodes. Children with a long history of predisposing factors such as IBD need particular attention to the possibility of colorectal cancer. Early diagnosis through regular screening with colonoscopy is one of the most important critical factors for a good prognosis.
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21
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Childhood, adolescents, and young adults (≤25 y) colorectal cancer: study of Anatolian Society of Medical Oncology. J Pediatr Hematol Oncol 2013; 35:83-9. [PMID: 23337551 DOI: 10.1097/mph.0b013e31827e7f20] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate the clinicopathologic characteristics and treatment outcomes of young patients with colorectal cancer (CRC). METHODS Between May 2003 and June 2010, 76 patients were found eligible for this retrospective study. Age, sex, presenting symptoms, patients with acute presentation, family history, presence of polyps, histologic features, localization and stage of the tumor, treatment outcomes, time and site of recurrence, sites of metastasis, and survival outcomes were recorded from the patient files. RESULTS Seventy-six patients (55.3% male) with a median age of 23 years were evaluated. Patients were evaluated in 2 groups as follows: child-adolescent (0 to 19 y, n=20) and young adult (20 to 25 y, n=56). Sex and symptoms (abdominal pain and rectal bleeding) were significantly differed between the groups and acute presentation was close to statistical significance. Overall survival significantly increased in patients undergoing curative surgery (P<0.001). Other parameters affecting the survival was stage of disease (P=0.004). Response to palliative chemotherapy in metastatic patients (P=0.042) and postoperative adjuvant chemotherapy had a statistically significant survival advantage (P=0.028). CONCLUSIONS Diagnosis of CRC should not be excluded solely on the basis of age. CRC features in young-adult patients are more similar to adults compared with that of child-adolescent patients according to the symptoms and presentation. In patients with CRC in this age group, curative surgery, adjuvant chemotherapy, and palliative chemotherapy provide survival advantage.
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22
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Tay CH, Lee HC, Yeung CY, Chan WT, Jiang CB, Liang DC. Different clinical manifestations between primary gastrointestinal malignancies and benign tumors in children. J Pediatr Gastroenterol Nutr 2012; 55:440-444. [PMID: 22343909 DOI: 10.1097/mpg.0b013e31824e88eb] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The purpose of the present study was to review the different clinical manifestations of primary gastrointestinal (GI) malignancies and benign tumors in pediatric patients. METHODS The demographic data, duration to diagnosis, clinical features, laboratory data, location and pathology of the tumors, and outcomes of pediatric patients from January 1984 to December 2009 were retrospectively reviewed. RESULTS A total of 24 GI malignancies and 62 benign tumors were diagnosed. Patients in the benign group were mostly diagnosed in the first decade of life (73%), whereas majority of patients with malignancies were older than 10 years (79%). The most common tumor location in the benign group was the colorectum, whereas in the malignant group, tumors were distributed equally in the small intestine and colorectum. The median duration from onset to diagnosis in the benign group was longer than that of the malignant group (P>00.05). There was statistically significant increase in the presence of hematochezia in patients with benign tumor compared with those with malignancy (P<00.05). Among the malignancies, 79% presented with abdominal pain, followed by weight loss (25%), anorexia (25%), palpable mass (25%), and fever (21%), with statistically significant differences compared with the benign group (P<00.05). Anemia was found in 47% to 63% of patients in both groups (P>00.05). Two patients with polyposis subsequently developed malignancy. CONCLUSIONS Different manifestations of GI malignancies and benign tumors may help pediatricians to detect these early. Patients with polyposis should be aware of the risk of malignant change.
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Affiliation(s)
- Chow-Hong Tay
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
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23
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Singer G, Hoellwarth ME. Colorectal carcinomas in children: an institutional experience. Pediatr Surg Int 2012; 28:591-5. [PMID: 22526552 DOI: 10.1007/s00383-012-3090-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Colorectal carcinoma (CRC) is a rare malignancy in children. Due to its rarity this disease is seldom suspected in children and adolescents suffering from abdominal symptoms. Therefore, diagnosis is often delayed. The aim of the present study was to raise attention to this diagnosis and to present three very special cases of CRC in children treated at our department. METHODS Patients' charts of all children treated at our department with colorectal carcinomas between 2000 and 2010 were analyzed. RESULTS In the last 10 years three cases of CRC have been treated. The first patient was diagnosed a colon carcinoma following treatment of appendicitis, while the colon carcinoma could be resected without a recurrence. The genetic analysis demonstrated a high microsatellite instability. Subsequently, 4 years later, the patient developed an inoperable astrocytoma leading to the final diagnosis of a Turcot's syndrome. The second patient developed a colon carcinoma as a true second malignancy 10 years following an osteosarcoma. The third patient was diagnosed primarily with multiple metastases of a carcinoma of the descending colon. All three patients died 7, 8 and 11 years, respectively, following diagnosis. CONCLUSION Albeit colon carcinomas in children are exceedingly rare, this diagnosis has to be considered in cases of unclear abdominal pain. Early recognition combined with radical surgery represents the mainstay of treatment of this disease in children.
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Affiliation(s)
- Georg Singer
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria.
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24
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Koczka CP, Goodman A. Metastatic signet ring colon cancer in a Caribbean young adult and review of the literature. Eur J Gastroenterol Hepatol 2012; 24:731-4. [PMID: 22422005 DOI: 10.1097/meg.0b013e328352819d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Colorectal cancer is the third most common neoplasm diagnosed in the USA, with less than 3% of patients younger than 40 years. Although most of the literature indicates that younger patients present with a higher stage and grade of cancer, mortality is not clearly correlated. Furthermore, the literature pertaining to colorectal cancer in the nonwhite youth is limited. In this case report, we report a case of aggressive colorectal cancer metastasizing in a young Afro-Caribbean woman with no known risk factors. The aim of this report is to raise awareness of this entity in the younger population, particularly in Afro-Caribbeans, which remains a highly understudied group compared with the rest of the US population.
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25
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Abstract
Colorectal Carcinoma (CRC) is rare in patients less than 20 years of age. Although presenting symptoms are similar to adults, this diagnosis is rarely considered in the initial differential diagnosis of young patients. We will review what is published about the incidence, epidemiology, and clinical presentation of CRC in children, adolescents and young adults. Because of its rarity in this age group, few pediatric oncologists will have experience with CRC, and clinical trials will rarely be available. The treatment of CRC in adults is evolving rapidly and consultation with medical oncologists experience in treating adults with CRC is essential to develop the best treatment plan for a young patient diagnosed with CRC.
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26
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Adibe OO, Sharp RJ. Colon cancer with microsatellite instability in a 13-year-old Hispanic male. J Clin Oncol 2012; 30:e55-7. [PMID: 22184386 DOI: 10.1200/jco.2011.38.2549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Obinna O Adibe
- Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, MO 64018, USA.
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27
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28
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Choi IS, Kook H, Kim DY, Han DK, Baek HJ, Suh KW, Kim YJ, Lee JH, Hwang TJ. Disseminated colon cancer in a 15-year-old boy after immunosuppression for aplastic anemia. Pediatr Int 2010; 52:307-9. [PMID: 20500480 DOI: 10.1111/j.1442-200x.2010.03025.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Ic S Choi
- Department of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea
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Colon mucinous adenocarcinoma in childhood: a case report with emphasis on image findings. Case Rep Med 2010; 2010:327634. [PMID: 20369060 PMCID: PMC2847379 DOI: 10.1155/2010/327634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Accepted: 03/09/2010] [Indexed: 11/17/2022] Open
Abstract
Colorectal cancer is extremely rare in children. We report a case of a 12-year-old boy who presented with a five-month history of weight loss and anorexia, associated with vomiting episodes, dizziness, fatigue, and dyspnea. On physical examination, a palpable abdominal mass was noticed on the right hypochondrium and flank. An imaging study was performed, which showed a solid mass on the right colon. The patient underwent incisional surgical biopsy, and subsequent histopathologic analysis revealed a colon mucinous adenocarcinoma.
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Sultan I, Rodriguez-Galindo C, El-Taani H, Pastore G, Casanova M, Gallino G, Ferrari A. Distinct features of colorectal cancer in children and adolescents: a population-based study of 159 cases. Cancer 2010; 116:758-65. [PMID: 19957323 DOI: 10.1002/cncr.24777] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
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 histotype in both adults and pediatric patients; however, children/adolescents had more unfavorable histotypes (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% +/- 4.2% and 60% +/- 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.
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Affiliation(s)
- Iyad Sultan
- Department of Pediatric Oncology, King Hussein Cancer Center, Amman, Jordan.
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Colon carcinoma in children and adolescents: prognostic factors and outcome-a review of 11 cases. Pediatr Surg Int 2009; 25:1073-6. [PMID: 19816697 DOI: 10.1007/s00383-009-2491-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2009] [Indexed: 02/06/2023]
Abstract
BACKGROUND Carcinoma of the colon and rectum is rare in the pediatric age group, and usually presents with an advanced stage disease bearing a poor prognosis. Colorectal carcinoma should be considered in children with signs of intestinal obstruction, alteration in bowel habits, gastrointestinal bleeding and chronic abdominal pain. We performed a retrospective study to evaluate the clinical characteristics, and prognosis of these patients. METHODS Between 1974 and 2007, 11 patients were identified and treated for colorectal carcinoma at the Oncology Unit. The medical records were studied to analyze the age, sex, clinical presentation, diagnostic procedures, extent of disease (Dukes staging), treatment, histological types, and outcome. RESULTS There were seven boys and four girls ranging from 7 to 17 of age. Predisposing diseases and syndromes were encountered in three children, (1 with Turner's syndrome and two with adenomatous familial polyposis). Abdominal pain, acute intestinal obstruction, rectal bleeding and weight loss were the commonest symptoms. Surgical procedures were done in 11 patients (incomplete resection with segmental resection in 4 patients, complete resection in the other 4, and biopsy alone in 3 patients).The predominant histological type was mucinous carcinoma. Seven patients received adjuvant chemotherapy, all of whom did not survive. Two patients died shortly after initial surgery, and two patients are alive, and well. CONCLUSIONS Colorectal carcinoma in children is very uncommon and could be easily misdiagnosed, resulting in advanced stage disease at diagnosis. Because radical surgery which is the mainstay of treatment is possible only in patients with early stage disease, a high level of awareness and early diagnosis are critical.
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Adénocarcinome du rectum chez 1 enfant de 14 ans. Arch Pediatr 2008; 15:1656-9. [DOI: 10.1016/j.arcped.2008.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Revised: 06/06/2008] [Accepted: 08/01/2008] [Indexed: 11/19/2022]
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Abstract
Colorectal carcinoma (CRC), although primarily a disease of adulthood, accounts for 2% of malignancies in adolescents and has been reported in children as young as 9 months of age. Our knowledge of CRC in pediatrics is based on a handful of case series and case reports. Apart from one small clinical trial, there has been a lack of prospective clinical studies in this age group. Based on these published reports, most CRC in children is sporadic, but it can also arise in the setting of predisposing conditions, such as gastrointestinal polyposis syndromes, nonpolyposis familial cancer syndromes, and inflammatory bowel disease. Despite some similarities to adult disease, CRC in childhood may be intrinsically different biologically, because it differs from adult-onset CRC in several respects. Childhood CRC tends to be diagnosed at an advanced stage, is largely of mucinous histology, and (probably because of these features) tends to have a poorer outcome. As a result of its rarity in children and the lack of prospective pediatric studies, recommendations for therapy are primarily extrapolated from adult clinical trials. A review of pediatric case series in the English literature emphasizes the prognostic significance of stage of disease, as well as extent of surgical resection. As in adults, early detection is critical in an effort to capture the disease at less advanced stages. Complete surgical resection with aggressive lymph node dissection is essential for cure, and neoadjuvant chemotherapy may be used in an effort to render unresectable lesions resectable. Active agents in adults with CRC include fluorouracil, folinic acid (leucovorin), oxaliplatin, and irinotecan. Furthermore, newer targeted therapeutic agents, such as bevacizumab and cetuximab, have added additional efficacy to the standard chemotherapy backbone. Collaborative multi-institutional pediatric clinical trials are needed to evaluate the prognosis, optimal treatment response, and the basic biology of childhood onset CRC.
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Affiliation(s)
- Raya Saab
- Pediatric Hematology-Oncology, American University of Beirut, Beirut, Lebanon
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Ferrari A, Rognone A, Casanova M, Zaffignani E, Piva L, Collini P, Bertario L, Sala P, Leo E, Belli F, Gallino G. Colorectal carcinoma in children and adolescents: the experience of the Istituto Nazionale Tumori of Milan, Italy. Pediatr Blood Cancer 2008; 50:588-93. [PMID: 17405155 DOI: 10.1002/pbc.21220] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Colorectal carcinoma (CRC) is one of the most common tumors in adults, but extremely rare in young age. This study retrospectively reports on a group of 27 patients <30 years of age, and particularly on 7 cases <18 years old, treated at the Istituto Nazionale Tumori, Milan, Italy, between 1985 and 2005. PATIENTS AND METHODS Among the children/adolescents (age 9-18, median 12 years), 5/7 had unfavorable CRC histotypes (poorly differentiated or mucinous adenocarcinoma) and all but one had advanced disease at onset. Initial surgical resection was complete in 5/7 cases, and all patients received postoperative chemotherapy. RESULTS In the subset of patients <18 years, 6/7 had tumor progression or relapse, and 5 died of their tumor: overall survival (OS) was 23% at 5 years. In the group of 19- to 29-year-olds (young adults), 5-year OS was 72.6%. CONCLUSIONS This study confirms the rarity and poor prognosis of CRC in children and adolescents: advanced stage and an aggressive biology are hallmarks of this tumor in pediatric age, while clinical findings and outcome in young adults seem more similar to those observed in adult series. Therapeutic recommendations should stay the same as for adults. Surgery remains the mainstay of treatment and early diagnosis is crucial: it is important for pediatricians to be aware that CRC does occur in children, in order to refer suspected cases to expert physicians professionally dedicated to the management of this cancer in adults.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy.
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Reingruber B, Boettcher MI, Klein P, Hohenberger W, Pelz JOW. Hyperthermic intraperitoneal chemoperfusion is an option for treatment of peritoneal carcinomatosis in children. J Pediatr Surg 2007; 42:E17-21. [PMID: 17848227 DOI: 10.1016/j.jpedsurg.2007.06.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Gastrointestinal carcinomas in childhood are rare and frequently present at an advanced stage. Besides lymphatic and distant organ metastasis, peritoneal carcinomatosis may be detected and has a poor prognosis. In addition to surgery and intravenous chemotherapy, hyperthermic intraperitoneal chemoperfusion (HIPEC) may be an option for selected patients. Our aim was to demonstrate the feasibility of the method and to discuss possible indications. METHODS After treating a series of adult patients, HIPEC for peritoneal carcinomatosis from a signet cell carcinoma of the colon was performed intraoperatively in a 12-year-old boy. We gave mitomycin C at a dose of 30 mg/m2 over 90 minutes at maximum temperature of 41.2 degrees C. We performed intraoperative drug level monitoring and daily postoperative liver and kidney function tests and differential blood counts. RESULTS Hyperthermic intraperitoneal chemoperfusion was performed according to protocol without complications. Perfusate and venous drug levels were similar to those in an adult case. The patient had an uneventful recovery, and serum chemistry and blood count returned to normal after a week. The boy lived for 36 months after initial presentation. Sixteen months after HIPEC, still with excellent quality of life, an elevated carcinoembryonic antigen (CEA) indicated recurrence. Thirty months after HIPEC, he died of progressive recurrent disease. CONCLUSIONS Hyperthermic intraperitoneal chemoperfusion as performed in adults may be beneficial to children with peritoneal carcinomatosis and merits further study.
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Affiliation(s)
- Bertram Reingruber
- Division of Pediatric Surgery, Department of Surgery, Friedrich-Alexander-University, 91054 Erlangen, Germany.
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Kravarusic D, Feigin E, Dlugy E, Steinberg R, Baazov A, Erez I, Lazar L, Kapuller V, Grunspan M, Ash S, Freud E. Colorectal carcinoma in childhood: a retrospective multicenter study. J Pediatr Gastroenterol Nutr 2007; 44:209-11. [PMID: 17255833 DOI: 10.1097/01.mpg.0000252195.84084.52] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Colorectal carcinoma, a common adult malignancy, has an estimated childhood incidence of 0.3 to 1.5/million in Western countries and 0.2/million in Israel. Diagnosis is difficult because adult screening measures are unfeasible in children. The tumor is frequently associated with predisposing genetic factors, aggressive biological behavior, and poor prognosis. The aim of this multicenter study was to document the clinical profile, treatment and prognosis of colorectal carcinoma in children in Israel. PATIENTS AND METHODS The clinical, laboratory, therapeutic, and prognostic parameters of all 7 children from 4 medical centers in Israel who were diagnosed with colorectal carcinoma over a 25-y period were reviewed. RESULTS Patients presented with rectal bleeding (4 of 7), abdominal pain (2 of 7), and abdominal distension (2 of 7). Average time to diagnosis was 6 months. Six patients underwent surgery (1 refused), and 5 received chemotherapy. Histopathological studies showed poorly differentiated mucinous adenocarcinoma, signet-ring type, in 4 cases, moderately differentiated adenocarcinoma in 2, and well-differentiated carcinoma in 1. Three patients died of the disease, 2 shortly after diagnosis. One patient with recurrent metastatic disease was lost to follow-up. CONCLUSION Colorectal carcinoma in children is characterized by aggressive tumor behavior and delayed diagnosis, resulting in a worse prognosis than in adults. Heightened physician awareness of the possibility of this disease in children, with special attention to adolescents with predisposing factors and rectal bleeding, could help to improve outcome.
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Affiliation(s)
- Dragan Kravarusic
- Department of Pediatric Surgery, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel
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Abstract
Tumors of the pediatric gastrointestinal tract are extremely rare. Their infrequent presentation at treatment centers has not allowed for the development of standardized treatment protocols and prospective review. The most prevalent gastrointestinal neoplasms and malignancies are described, including gastrointestinal lymphoma, colorectal carcinoma, carcinoid tumors, gastrointestinal stromal tumors, leiomyomas, juvenile polyps, inflammatory pseudotumors, gastric tumors, and Peutz-Jeghers polyposis syndrome. Current recommendations for the medical and surgical management of these tumors are reviewed and summarized for this vast group of gastrointestinal neoplasms in children.
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Affiliation(s)
- Alan P Ladd
- Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
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