title: Colon carcinoma in childhood: review of the literature with four case reports.
abstract: OBJECTIVE
  Colorectal cancer (CRC) in childhood is extremely rare, and only a few case reports exist. We hereby present four cases of childhood CRC along with a literature review.
  
  
  METHODS
  A retrospective review of four cases from our institute was conducted, and 15 articles from PubMed describing childhood CRC were reviewed.
  
  
  RESULTS
  
  
  
  METHODS
  Four patients ranging in age from 11 to 14 years were treated for colon cancer between the years 2000 and 2011. The presenting symptoms varied and included abdominal pain, nausea, vomiting, diarrhea, constipation, and hematochezia, with symptom duration ranging from a few days to 4 months. No patient had a predisposing disease or syndrome. All patients underwent surgical resections, with the most prevalent histology being mucinous adenocarcinoma. Despite radical surgery followed by systemic chemotherapy, the disease progressed in all patients.
  
  
  METHODS
  A total of 239 cases were reviewed. The youngest patient was 6 years old. The most frequent predisposing conditions were hereditary nonpolyposis colorectal cancer and familial adenomatous polyposis. Most of the patients presented advanced stage, with the most common histopathologic diagnosis being mucinous adenocarcinoma, followed by poorly differentiated adenocarcinoma and signet ring cell carcinoma. Even though most of the patients underwent aggressive treatment, the overall prognosis was poor.
  
  
  CONCLUSIONS
  Childhood CRC has an aggressive pathology and distinct genetic features, which result in an advanced stage at diagnosis and consequently a poor prognosis. Although the incidence is very low, every physician should be aware of CRC as a possible childhood diagnosis.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea. gangmikim@gmail.com
authors.forename: Gangmi
authors.initials: G
authors.lastname: Kim
authors.forename: Seung Hyuk
authors.initials: SH
authors.lastname: Baik
authors.forename: Kang Young
authors.initials: KY
authors.lastname: Lee
authors.forename: Hyuk
authors.initials: H
authors.lastname: Hur
authors.forename: Byung Soh
authors.initials: BS
authors.lastname: Min
authors.forename: Chuhl Joo
authors.initials: CJ
authors.lastname: Lyu
authors.forename: Nam Kyu
authors.initials: NK
authors.lastname: Kim
mesh_terms: D002648:Child; D003110:Colonic Neoplasms / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male