Colon Cancer with Appendiceal Perforation in a 13-year-old Boy

충수염으로 오인된 소아의 대장암

  • Choi, Myung-Min (Department of Surgery Gachon University of Medicine, Gil Hospital) ;
  • Lee, Un-Gi (Department of Surgery Gachon University of Medicine, Gil Hospital) ;
  • Jeon, In-Sang (Department of Pediatrics, Gachon University of Medicine, Gil hospital) ;
  • Kim, Hyun-Young (Department of Surgery Gachon University of Medicine, Gil Hospital)
  • 최명민 (가천의과대학병원 길병원 외과학교실) ;
  • 이운기 (가천의과대학병원 길병원 외과학교실) ;
  • 전인상 (가천의과대학병원 길병원 소아과학교실) ;
  • 김현영 (가천의과대학병원 길병원 외과학교실)
  • Received : 2008.05.21
  • Accepted : 2008.12.08
  • Published : 2008.12.31

Abstract

Colorectal cancer is extremely rare in children. Unlike adult colorectal cancer, the overall prognosis of colorectal cancer in children is poor. Delayed diagnosis, advanced stages of the disease at presentation, and mucinous type of histology are the major determinants of poor outcome in childhood. A 13-year-old boy with abdominal pain visited our hospital. Physical examination andabdominal ultrasonography identified acute appendicitis with perforation. He underwent appendectomy and then the pathologic findings revealed mucinous adenocarcinoma. The cancer was located at the transverse colon and had metastases on peritoneal wall at $2^{nd}$ laparotomy. Extended right hemicolectomy was performed. He underwent palliative chemotherapy. After 4 months later, hepatic metastasis and aggravated peritoneal seedings developed. He died of renal failure and pneumonia 13 months after operation. We need to have a high index of suspicion for the possibility of a malignant colorectal tumor in any childhood case with nonspecific signs and symptoms.

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