Sule A Z, Mandong B M
Department of Surgery and Histopathology, Jos University Teaching Hospital, Nigeria.
Cent Afr J Med. 1999 Aug;45(8):209-12. doi: 10.4314/cajm.v45i8.8486.
To review malignant colorectal tumour arising in patients 30 years and below.
Retrospective cross sectional descriptive study.
Jos University Teaching Hospital, Jos, Nigeria.
A total of 35 patients 30 years and below.
Occurrence of malignant colorectal tumours tends to be higher among men and women over age 65 years and more common among Whites than Blacks. The disease rarely presents in the young population and the prognosis is usually unfavourable. This may be due to a delay in the diagnosis because colorectal cancer is not usually considered first in this age group.
15 patients had abdomino-perineal excision of the rectum, two right hemicolectomy, one left hemicolectomy, two anterior resection and six had colostomy and biopsy.
Altogether, 149 patients were treated for large bowel cancer. From then, 35 (23.6%) given a yearly incidence of 3.5 were 30 years old or younger. The mean age was 25 (STD +/- 6) years, while the M:F ratio was 1.2:1. Weight loss, bloody mucoid diarrhoea, tenesmus and an anorectal mass were common clinical features present for more than six months. The rectum was involved in 24 patients (68.6%) and adenocarcinoma either well/moderately well differentiated or poorly differentiated was the predominant histological type. All the cancers except four were advanced at first presentation and treatment was merely palliative with only 30% of those treated and followed up still alive at six months. Complications of surgery were considered minor with the exception of the pelvic abscesses and deaths were due to the effects of the disease.
This study illustrates that colorectal cancer is not rare, as it was previously believed. Presentation is commonly late and prognosis poor. In this age group, malignant colorectal tumours should frequently be considered in the differential diagnosis of bowel symptoms. The importance of the prudence of the general practitioner is thus emphasized.
回顾30岁及以下患者发生的恶性结直肠肿瘤。
回顾性横断面描述性研究。
尼日利亚乔斯市乔斯大学教学医院。
共35例30岁及以下患者。
65岁以上男性和女性中恶性结直肠肿瘤的发生率往往较高，且在白人中比黑人更常见。该疾病在年轻人群中很少出现，预后通常不佳。这可能是由于诊断延迟，因为结直肠癌在这个年龄组通常不是首先考虑的疾病。
15例患者接受了腹会阴直肠切除术，2例接受了右半结肠切除术，1例接受了左半结肠切除术，2例接受了前切除术，6例接受了结肠造口术和活检。
共有149例患者接受了大肠癌治疗。从那时起，35例（23.6%）年龄在30岁及以下，年发病率为3.5。平均年龄为25岁（标准差±6），男女比例为1.2:1。体重减轻、血性黏液便、里急后重和肛门直肠肿块是持续超过6个月的常见临床特征。24例患者（68.6%）直肠受累，腺癌无论是高分化/中分化还是低分化都是主要的组织学类型。除4例患者外，所有癌症在初次就诊时均为晚期，治疗仅为姑息性治疗，治疗并随访的患者中只有30%在6个月时仍存活。手术并发症除盆腔脓肿外被认为较轻，死亡是由疾病的影响导致的。
本研究表明，结直肠癌并不像以前认为的那样罕见。就诊通常较晚，预后较差。在这个年龄组，肠道症状的鉴别诊断中应经常考虑恶性结直肠肿瘤。因此强调了全科医生谨慎诊断的重要性。
