Advanced colorectal carcinoma with testicular metastasis in an adolescent: a case report
Abstract Background Colorectal carcinoma in the pediatric age group is rare and tends to be very aggressive and present late, due to which it has a very poor prognosis. It may present with distant metastasis; however, metastasis to the testes is very rare and signifies an advanced stage of the disea...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-10-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13256-018-1831-8 |
| _version_ | 1819130453553053696 |
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| author | Adarsh Pratap Singh Amit Kumar Anita Dhar Shipra Agarwal Sudhir Bhimaniya |
| author_facet | Adarsh Pratap Singh Amit Kumar Anita Dhar Shipra Agarwal Sudhir Bhimaniya |
| author_sort | Adarsh Pratap Singh |
| collection | DOAJ |
| description | Abstract Background Colorectal carcinoma in the pediatric age group is rare and tends to be very aggressive and present late, due to which it has a very poor prognosis. It may present with distant metastasis; however, metastasis to the testes is very rare and signifies an advanced stage of the disease. Surgery is the only effective modality to cure patients with localized colorectal carcinomas. However, statistics show a higher incidence of unresectable disease and a higher metastasis rate in childhood colorectal carcinomas. We present a case of advanced colorectal carcinoma with testicular metastasis in an adolescent. Case presentation A 15-year-old Indian Hindu boy presented to surgical emergency with signs and symptoms of intestinal obstruction. He also had a history of passing blood and mucus per rectum. On examination he had abdominal distension. On digital rectal examination, a circumferential proliferative growth was felt 1 cm above the anal verge. On scrotal examination, a small nodule was felt in his right testis. In view of intestinal obstruction, he was taken into our emergency operation theater and a diverting loop sigmoid colostomy was performed to relieve the obstruction. A punch biopsy from anorectal growth was taken which suggested signet ring cell adenocarcinoma. Contrast-enhanced computed tomography of his chest, abdomen, and pelvis showed advanced colorectal carcinoma with distant metastasis. Ultrasonography of his testes showed a hypoechoic nodule in the right testis from which a needle aspiration biopsy was done which revealed metastatic adenocarcinoma. Conclusions Childhood colorectal carcinomas have a very poor prognosis due to their aggressive nature and late presentation. In spite of all the advances in diagnosis and treatments, the overall long-term survival is still dismal in these patients. Due to the rarity of this disease, screening is not recommended for individuals under the age of 50. Thus, to improve outcome, early diagnosis and treatment is paramount. For that to happen, awareness needs to be created regarding pediatric colorectal carcinoma and its signs and symptoms. |
| first_indexed | 2024-12-22T08:59:51Z |
| format | Article |
| id | doaj.art-d2931c26e9bf4fbd90d990511c03aed7 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-22T08:59:51Z |
| publishDate | 2018-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-d2931c26e9bf4fbd90d990511c03aed72022-12-21T18:31:45ZengBMCJournal of Medical Case Reports1752-19472018-10-011211610.1186/s13256-018-1831-8Advanced colorectal carcinoma with testicular metastasis in an adolescent: a case reportAdarsh Pratap Singh0Amit Kumar1Anita Dhar2Shipra Agarwal3Sudhir Bhimaniya4Department of Surgery, AIIMSDepartment of Surgery, AIIMSDepartment of Surgery, AIIMSDepartment of Pathology, AIIMSDepartment of Cardiovascular Radiology, AIIMSAbstract Background Colorectal carcinoma in the pediatric age group is rare and tends to be very aggressive and present late, due to which it has a very poor prognosis. It may present with distant metastasis; however, metastasis to the testes is very rare and signifies an advanced stage of the disease. Surgery is the only effective modality to cure patients with localized colorectal carcinomas. However, statistics show a higher incidence of unresectable disease and a higher metastasis rate in childhood colorectal carcinomas. We present a case of advanced colorectal carcinoma with testicular metastasis in an adolescent. Case presentation A 15-year-old Indian Hindu boy presented to surgical emergency with signs and symptoms of intestinal obstruction. He also had a history of passing blood and mucus per rectum. On examination he had abdominal distension. On digital rectal examination, a circumferential proliferative growth was felt 1 cm above the anal verge. On scrotal examination, a small nodule was felt in his right testis. In view of intestinal obstruction, he was taken into our emergency operation theater and a diverting loop sigmoid colostomy was performed to relieve the obstruction. A punch biopsy from anorectal growth was taken which suggested signet ring cell adenocarcinoma. Contrast-enhanced computed tomography of his chest, abdomen, and pelvis showed advanced colorectal carcinoma with distant metastasis. Ultrasonography of his testes showed a hypoechoic nodule in the right testis from which a needle aspiration biopsy was done which revealed metastatic adenocarcinoma. Conclusions Childhood colorectal carcinomas have a very poor prognosis due to their aggressive nature and late presentation. In spite of all the advances in diagnosis and treatments, the overall long-term survival is still dismal in these patients. Due to the rarity of this disease, screening is not recommended for individuals under the age of 50. Thus, to improve outcome, early diagnosis and treatment is paramount. For that to happen, awareness needs to be created regarding pediatric colorectal carcinoma and its signs and symptoms.http://link.springer.com/article/10.1186/s13256-018-1831-8AdolescentColorectal carcinomaTesticular metastasisIntestinal obstructionSignet ring cell adenocarcinomaPoor prognosis |
| spellingShingle | Adarsh Pratap Singh Amit Kumar Anita Dhar Shipra Agarwal Sudhir Bhimaniya Advanced colorectal carcinoma with testicular metastasis in an adolescent: a case report Journal of Medical Case Reports Adolescent Colorectal carcinoma Testicular metastasis Intestinal obstruction Signet ring cell adenocarcinoma Poor prognosis |
| title | Advanced colorectal carcinoma with testicular metastasis in an adolescent: a case report |
| title_full | Advanced colorectal carcinoma with testicular metastasis in an adolescent: a case report |
| title_fullStr | Advanced colorectal carcinoma with testicular metastasis in an adolescent: a case report |
| title_full_unstemmed | Advanced colorectal carcinoma with testicular metastasis in an adolescent: a case report |
| title_short | Advanced colorectal carcinoma with testicular metastasis in an adolescent: a case report |
| title_sort | advanced colorectal carcinoma with testicular metastasis in an adolescent a case report |
| topic | Adolescent Colorectal carcinoma Testicular metastasis Intestinal obstruction Signet ring cell adenocarcinoma Poor prognosis |
| url | http://link.springer.com/article/10.1186/s13256-018-1831-8 |
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