Colorectal carcinoma, a common adult malignancy, has an estimated childhood incidence over 1 million in Western countries and less than 1 million in Israel.
Diagnosis is difficult because adult screening measures are unfeasible in children.
The tumor is frequently associated with predisposing genetic factors, aggressive biological behavior, and poor prognosis.
Dr Dragan Kravarusic and colleagues documented the clinical profile, treatment and prognosis of colorectal carcinoma in children.
| Poorly differentiated mucinous adenocarcinoma was found in 4 cases|
|Journal of Pediatric Gastroenterology & N|
The clinical, laboratory, therapeutic, and prognostic parameters of all 7 children diagnosed with colorectal carcinoma over a 25-year period were reviewed.
The investigative team identified rectal bleeding in 4 patients, abdominal pain in 2, and abdominal distension in 2.
Average time to diagnosis was 6 months.
The investigators found that 6 patients underwent surgery, and 5 received chemotherapy.
Histopathological studies showed poorly differentiated mucinous adenocarcinoma, signet-ring type, in 4 cases.
The team found moderately differentiated adenocarcinoma in 2, and well-differentiated carcinoma in 1 case.
The investigators noted that 3 patients died of the disease, of which 2 died shortly after diagnosis.
The investigative team reported that 1 patient with recurrent metastatic disease was lost to follow-up.
Dr Kravarusic's team concludes, “Colorectal carcinoma in children is characterized by aggressive tumor behavior and delayed diagnosis, resulting in a worse prognosis than in adults.”
“Heightened physician awareness of the possibility of this disease in children, with special attention to adolescents with predisposing factors and rectal bleeding, could help to improve outcome.”