Colorectal cancer in pediatric with obstructive symptoms: a rare case report

Abstract

Introduction: Colorectal cancer or known as CRC, is rare among adolescents younger than 20 years old. CRC diagnosis in children is commonly delayed until it reaches the advanced stage due to the nonspecific symptoms mimicking other gastrointestinal disorders. Most CRC in children is poorly differentiated mucinous adenocarcinoma, in contrast to CRC in adults, mostly moderately or well-differentiated adenocarcinoma. The delay in diagnosing CRC in children leads to an extremely poor prognosis rather than adults. Thus, this article aimed to report a rare case related to the CRC in pediatric.Case presentation: A rare case of a 14-year-old male present with abdominal distention since a month before presented to the emergency department. He also complained of bilious vomiting and not passing stool for three days, there was decreased body mass of about 15 kilograms since a year ago, and a family history of malignancy was refused. There was a distended abdomen, arm contour and metallic sound. The full blood count showed no significant results. We found a dilated prominent bowel filled with air in the entire abdomen from plain abdominal radiography that led us to suspect total bowel obstruction. We decided to do an emergency exploratory laparotomy. Intraoperatively, we found multiple masses look like polyposis in the intraluminal of a descending colon ranging about 10 centimeters long. The histopathological finding showed adenocarcinoma well-differentiated colon T3N0. Postoperatively, there were no complications from the surgery until a month after surgery, and we suggested our patient continue his treatment with adjuvant chemotherapy.Conclusion: The treatment of colorectal cancer in pediatric is complete surgical resection of the tumor and chemotherapy. Early detection of colorectal cancer is required to prevent further morbidity and mortality.