A case of rectal cancers in teenager: a conundrum of genetics and clinical medicine

Moveendra Kumar and Mahadevan D.Tata and Nik Amin Sahid Nik Lah (2021) A case of rectal cancers in teenager: a conundrum of genetics and clinical medicine. Annals of Medicine and Surgery, 65. pp. 1-3. ISSN 2049-0801

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Introduction: Signet cell carcinoma (SRCC)of the rectum is a rare subtype of the rectum cancer which accounts for only 0.8% of colorectal cancer in adolescents and young adults (AYAs) which spread aggressively to other organs and peritoneum. Case presentation: We present a case of 15-year-old boy from rural area, presented with chronic diarrhea and per rectal bleeding for 3 months. The diagnosis was determined by colonoscope which revealed a fungating mass identified at 10cm from anal verge. Histological examination confirmed diagnosis of signet ring cell adenocarcinoma. CT scan of the abdomen showed thickening involving the recto-sigmoid colon and rectal mass, without evidence of distant metastatic disease. The patient's carcinoembryonic antigen level was within the normal range. He underwent a colostomy and was subjected to neoadjuvant CCRT and surgery. Discussion: This CASE highlights the importance and challenges in achieving early diagnosis and surgical intervention of signet-ring cell carcinoma in adolescents, as most cases are detected at an advanced stage coupled with the scarcity of information on these rarer subtypes which leads to a poor prognosis. Conclusion: In managing Signet cell carcinoma of the colorectal, physician have to know that it has a poor prognosis in patients of any age. However, in young teenagers delayed diagnosis and treatment option are narrowed to palliative management. Genetic profiling of family members and similar environment population may be a key to early detection.

Item Type: Article
Keyword: Adolescents and young adults , AYA , Rectal cancer , Signet cell adenocarcinoma
Subjects: R Medicine > RC Internal medicine > RC31-1245 Internal medicine > RC254-282 Neoplasms. Tumors. Oncology Including cancer and carcinogens
Department: FACULTY > Faculty of Medicine and Health Sciences
Depositing User: SAFRUDIN BIN DARUN -
Date Deposited: 09 Sep 2021 12:17
Last Modified: 09 Sep 2021 12:17
URI: https://eprints.ums.edu.my/id/eprint/29023

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