Non-familial paediatric colorectal cancers--an 18 years' experience

Primary gastrointestinal malignancies constitute only 1% of all paediatric neoplasms.

The aim of this study was to describe our 18 years' experience with non-familial paediatric colorectal malignancies, outlining pertinent features of diagnosis, treatment and outcome.

9 patients of non-familial paediatric colorectal malignancies were admitted in PGIMS, Rohtak, Haryana between 1990 and 2008. After the initial surgical management, the advanced cases underwent chemotherapy and radiation therapy where required and were followed up.

There were six male and three female patients (age range: 7 to 16 years). Three tumours arose in the rectum, three in the sigmoid colon, one each in the splenic flexure and appendix, and there was one case of diffuse colonic polyposis. All cases presented with obstruction and rectal bleeding. Two cases of sigmoid carcinoma were unresectable and expired 4 months post-surgery. The rest responded to radical resection. Three patients required palliative radiation therapy. Due to the advanced stage, chemotherapy was given to all the carcinoma patients. One patient had local recurrence after 5 months and another developed distant metastasis. The rest are on follow-up and clinically and radiologically disease free.

Paediatric colorectal malignancy is a rare entity, usually diagnosed in the later stages, culminating in advanced disease. A majority of cases undergo radical resection due to the advanced stage of presentation. Advanced stages may also require chemotherapy and radiation therapy.