Schistosoma-Associated Colorectal Carcinoma in a Young Male

Schistosomiasis is a parasitic disease that causes chronic intestinal inflammation, and certain Schistosoma species are implicated in colorectal carcinoma (CRC) pathogenesis. While common in endemic areas, Schistosoma-associated CRC (SA-CRC) is rarely reported in non-endemic countries. We describe a 19-year-old male with rectal carcinoma, likely linked to childhood freshwater exposure. He presented with rectal bleeding and prolapsing mass, underwent surgery, and histopathology confirmed poorly differentiated adenocarcinoma. Schistosoma parasite eggs were seen on histology and along with the environmental history supported the presumptive diagnosis of SA-CRC. He was treated with neoadjuvant chemoradiotherapy, surgery for the colorectal carcinoma and praziquantel for eradication of Schistosomiasis. This case emphasises the importance of detailed environmental exposure history in young onset CRC and highlights the potential oncogenic role of schistosomiasis.