학술논문

Two Cases of Pediatric Colorectal Cancer / 異なる経過をたどった小児大腸癌の2例
Document Type
Journal Article
Source
日本小児外科学会雑誌 / Journal of the Japanese Society of Pediatric Surgeons. 2019, 55(5):968
Subject
children
colorectal cancer
intussusception
mucinous carcinoma
signet ring cell carcinoma
印環細胞癌
大腸癌
小児
粘液癌
腸重積
Language
Japanese
ISSN
0288-609X
2187-4247
Abstract
We experienced treating two patients with colonic cancer diagnosed at school age and adolescence. Neither patient had a family history of cancer. [Case 1] A 14-year-old boy presented with the chief complaints of appetite loss and weight loss. He was referred to our hospital because of anemia and abdominal tumor noted on computed tomography (CT) images. Enhanced CT showed a circumferential elevated lesion in which the lumen was completely occluded along with multiple polyps. Left hemicolectomy and D2 + paraaortic lymph node dissection were performed. The resected tumor was diagnosed as adenocarcinoma, and the pathological stage was IV. Subsequently, chemotherapy was performed. However, he died one year after the operation owing to recurrence and metastasis. [Case 2] A 10-year-old boy presented with the chief complaints of bloody stool and abdominal pain. He was referred to our hospital owing to a diagnosis of intussusception based on contrast-enhanced CT findings. Emergency laparoscopic exploration was performed to assess the tumor. The tumor was suspected to be malignant lymphoma, and local excision was performed. The pathological diagnosis was mucinous carcinoma. Laparoscopic left hemicolectomy and lymph node dissection of D3 were performed similarly to the treatment of adult colon cancer. The final pathological diagnosis was stage IIIb, and chemotherapy was performed. The patient experienced no recurrence for two years after operation. [Conclusion] Colorectal cancer in children is extremely rare, but it is necessary to identify it correctly when gastrointestinal symptoms are prolonged.