Colorectal carcinomas in children: an institutional experience.

PURPOSE: Colorectal carcinoma (CRC) is a rare malignancy in children. Due to its rarity this disease is seldom suspected in children and adolescents suffering from abdominal symptoms. Therefore, diagnosis is often delayed. The aim of the present study was to raise attention to this diagnosis and to present three very special cases of CRC in children treated at our department.

METHODS: Patients' charts of all children treated at our department with colorectal carcinomas between 2000 and 2010 were analyzed.

RESULTS: In the last 10 years three cases of CRC have been treated. The first patient was diagnosed a colon carcinoma following treatment of appendicitis, while the colon carcinoma could be resected without a recurrence. The genetic analysis demonstrated a high microsatellite instability. Subsequently, 4 years later, the patient developed an inoperable astrocytoma leading to the final diagnosis of a Turcot's syndrome. The second patient developed a colon carcinoma as a true second malignancy 10 years following an osteosarcoma. The third patient was diagnosed primarily with multiple metastases of a carcinoma of the descending colon. All three patients died 7, 8 and 11 years, respectively, following diagnosis.

CONCLUSION: Albeit colon carcinomas in children are exceedingly rare, this diagnosis has to be considered in cases of unclear abdominal pain. Early recognition combined with radical surgery represents the mainstay of treatment of this disease in children.