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Colorectal carcinoma in children
I Karnak1, A O Ciftci, M E Senocak
1Department of Pediatric Surgery, Hacettepe University Medical Faculty, Ankara, Turkey.
Journal of Pediatric Surgery
|November 5, 1999
Summary
Childhood colorectal carcinoma is rare and aggressive. Delayed diagnosis, advanced stages, and mucinous histology predict poor outcomes, necessitating prompt evaluation in children with relevant symptoms.
Area of Science:
- Pediatric Oncology
- Gastrointestinal Oncology
- Clinical Trial Research
Background:
- Colorectal carcinoma in children is exceptionally rare.
- Presents with a poor prognosis, with limited data on management and follow-up.
Purpose of the Study:
- To evaluate clinical characteristics of childhood colorectal carcinoma.
- To identify predictors of poor outcomes in pediatric colorectal cancer patients.
Main Methods:
- Retrospective review of pediatric colorectal carcinoma cases (1972-1997).
- Data collected included demographics, clinical presentation, diagnostics, staging (modified Dukes), treatment, histology, and outcomes.
- Analysis focused on identifying factors associated with prognosis.
Main Results:
- 12 boys and 8 girls (ages 7-16) diagnosed with colorectal carcinoma.
- Predominant symptoms: abdominal pain, vomiting, rectal bleeding.
- All presented with advanced disease (Stage C or D).
- Mucinous adenocarcinoma was the predominant histological type (80%).
- High mortality rate observed, with delayed diagnosis and advanced stage as key factors.
Conclusions:
- Delayed diagnosis, advanced stage at presentation, and mucinous histology are critical determinants of poor prognosis.
- Pediatric colorectal malignancy should be considered in children with intestinal obstruction symptoms, abdominal pain, altered bowel habits, or GI bleeding.
- Age should not preclude consideration of colorectal malignancy; prompt, thorough evaluation is crucial for pediatric bowel disorders.