A Young Woman with High-Grade Rectosigmoid Adenocarcinoma, no Other Specified, T2n2aM0: A Case Report and Literature Review

Abstract

BACKGROUND: Colorectal cancer (CRC) is the fourth most common cancer in which the majority of CRCs are diagnosed between the ages of 50 and 70 years. Based on current trends, the incidence of colon and rectal cancers can increase by 124% in people aged 35–49 years and at the age of 20–34 will increase by 28% and 46%. OBJECTIVES: To report a case of a 24-year-old female patient with CRC. CASE REPORT: A 24-year-old female patient came to the Emergency Room at Bendan Hospital, Pekalongan City, with complaints of bleeding since 1 year ago. There are complaints in the past 6 months; the patient’s weight has decreased by up to 20 kg. Rectal toucher examination revealed normal (+) anal sphincter tone, a palpable mass in the anal canal, and was fragile; there were feces and blood in gloves. Abdominal ultrasonography found a solid tumor mass in the rectum area with a volume of 181 cc, suggesting a malignancy of the rectum. During a colonoscopy, a circular, fragile, and easily bleeding tumor was found, approximately 1 cm from the anal verge, and then biopsy was performed. Histopathological examination of the colon biopsy suggests a well-differentiated, rectosigmoid, NOS adenocarcinoma. The patient then underwent surgery using the Miles procedure technique. The patient’s condition after the operation improved, so after a week of treatment, the patient was able to undergo outpatient treatment. CONCLUSION: A complete history, physical examination, and supporting investigation are very useful in early detection of colorectal carcinoma, especially in young patients.