Colorectal carcinoma in an 11-year-old female: A case report

Abstract

Introduction: Colorectal carcinoma is a leading cancer and cause of mortality in the adult population but occurs rarely in the pediatric
population. The incidence of this tumour in the pediatric population is increasing worldwide. Diagnosis is often delayed in children,
with majority of their tumours being poorly differentiated. The purpose of this case report is to document the rare occurrence of this
tumour in a very young child and to increase its awareness in practicing doctors.
The case: We present a case of an 11-year-old female child with a 2 month history of recurrent constipation, 3-day history of abdominal distension and pain and a 2-day history of bilious projectile vomiting. An abdominal ultrasound scan detected distended loops of bowel with an assessment of intestinal obstruction of unknown cause. Surgery was a mid-line laparotomy with segmental bowel resection of splenic flexure tumour and divided colostomy. Pathological examination revealed a 15cm length of large bowel segment with a circumferential constricting tumour in the mid portion of its length. Histological examination revealed a mucinous adenocarcinoma. Patient received adjuvant chemotherapy, had reversal of colostomy and is doing well 5 months postoperatively with no recurrence.
Conclusion: Pediatric colorectal carcinoma cases are challenging due to their tendency to be misdiagnosed in addition to other bad prognostic factors often encountered. A complete assessment is necessary in all patients who present with clinical features suggestive of this disease regardless of age