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儿童结直肠癌:一项机构经验。

Colorectal carcinomas in children: an institutional experience.

作者信息

Singer Georg, Hoellwarth Michael E

机构信息

Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria.

出版信息

Pediatr Surg Int. 2012 Jun;28(6):591-5. doi: 10.1007/s00383-012-3090-x. Epub 2012 Apr 21.

Abstract

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.

摘要

目的

结直肠癌(CRC)在儿童中是一种罕见的恶性肿瘤。由于其罕见性,患有腹部症状的儿童和青少年很少被怀疑患有这种疾病。因此,诊断往往会延迟。本研究的目的是提高对这一诊断的关注,并介绍在我们科室接受治疗的三例非常特殊的儿童CRC病例。

方法

分析了2000年至2010年间在我们科室接受结直肠癌治疗的所有儿童的病历。

结果

在过去10年中,有三例CRC患者接受了治疗。第一例患者在阑尾炎治疗后被诊断为结肠癌,该结肠癌可切除且无复发。基因分析显示高度微卫星不稳定。随后,4年后,该患者发展为无法手术的星形细胞瘤,最终诊断为Turcot综合征。第二例患者在骨肉瘤后10年发生结肠癌,为真正的第二原发性恶性肿瘤。第三例患者最初被诊断为降结肠癌多发转移。所有三名患者分别在诊断后7年、8年和11年死亡。

结论

尽管儿童结肠癌极为罕见,但在腹痛原因不明的情况下必须考虑这一诊断。早期识别并结合根治性手术是儿童该疾病治疗的主要方法。

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