title: Colorectal carcinoma in childhood: a retrospective multicenter study.
abstract: OBJECTIVE
  Colorectal carcinoma, a common adult malignancy, has an estimated childhood incidence of 0.3 to 1.5/million in Western countries and 0.2/million in Israel. Diagnosis is difficult because adult screening measures are unfeasible in children. The tumor is frequently associated with predisposing genetic factors, aggressive biological behavior, and poor prognosis. The aim of this multicenter study was to document the clinical profile, treatment and prognosis of colorectal carcinoma in children in Israel.
  
  
  METHODS
  The clinical, laboratory, therapeutic, and prognostic parameters of all 7 children from 4 medical centers in Israel who were diagnosed with colorectal carcinoma over a 25-y period were reviewed.
  
  
  RESULTS
  Patients presented with rectal bleeding (4 of 7), abdominal pain (2 of 7), and abdominal distension (2 of 7). Average time to diagnosis was 6 months. Six patients underwent surgery (1 refused), and 5 received chemotherapy. Histopathological studies showed poorly differentiated mucinous adenocarcinoma, signet-ring type, in 4 cases, moderately differentiated adenocarcinoma in 2, and well-differentiated carcinoma in 1. Three patients died of the disease, 2 shortly after diagnosis. One patient with recurrent metastatic disease was lost to follow-up.
  
  
  CONCLUSIONS
  Colorectal carcinoma in children is characterized by aggressive tumor behavior and delayed diagnosis, resulting in a worse prognosis than in adults. Heightened physician awareness of the possibility of this disease in children, with special attention to adolescents with predisposing factors and rectal bleeding, could help to improve outcome.
authors.affiliation: Department of Pediatric Surgery, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
authors.forename: Dragan
authors.initials: D
authors.lastname: Kravarusic
authors.forename: Elad
authors.initials: E
authors.lastname: Feigin
authors.forename: Elena
authors.initials: E
authors.lastname: Dlugy
authors.forename: Ran
authors.initials: R
authors.lastname: Steinberg
authors.forename: Arthur
authors.initials: A
authors.lastname: Baazov
authors.forename: Ilan
authors.initials: I
authors.lastname: Erez
authors.forename: Ludvig
authors.initials: L
authors.lastname: Lazar
authors.forename: Vadim
authors.initials: V
authors.lastname: Kapuller
authors.forename: Moshe
authors.initials: M
authors.lastname: Grunspan
authors.forename: Shifra
authors.initials: S
authors.lastname: Ash
authors.forename: Enrique
authors.initials: E
authors.lastname: Freud
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000628:therapy*; D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002675:Child, Preschool; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents