Deng Wu, Sears Steve, Garand Susan, Farricielli Laurie
University of California, Irvine, USA.
BMJ Case Rep. 2013 Dec 11;2013:bcr2013200439. doi: 10.1136/bcr-2013-200439.
Colorectal carcinoma in the population aged less than 20 years of age is rare but associated with poor prognosis, which is attributable to advanced disease at presentation and higher incidence of the unfavourable mucinous histology. Colorectal carcinoma commonly presents with non-specific gastrointestinal symptoms in conjunction with iron deficiency anaemia. Many of these symptoms can mimic eating disorders, which are common in adolescent women. We present the case of a 20-year-old woman with previously undiagnosed familial adenomatous polyposis and colorectal carcinoma who experienced a significant delay in diagnosis, given a coexisting eating disorder mimicking her symptoms. After confirmation of the diagnosis by colonoscopy and genetic testing, the patient underwent a successful proctocolectomy and experienced full recovery. This case is a reminder that underlying organic pathology should always be excluded prior to a diagnosis of an eating disorder.
20岁以下人群的结直肠癌罕见，但预后较差，这归因于就诊时疾病已进展以及不良黏液组织学类型的发生率较高。结直肠癌通常表现为非特异性胃肠道症状并伴有缺铁性贫血。这些症状中的许多都可能类似饮食失调，而饮食失调在青春期女性中很常见。我们报告一例20岁女性病例，该患者既往未诊断出患有家族性腺瘤性息肉病和结直肠癌，由于同时存在类似其症状的饮食失调，诊断出现了显著延迟。经结肠镜检查和基因检测确诊后，患者成功接受了直肠结肠切除术并完全康复。该病例提醒我们，在诊断饮食失调之前，应始终排除潜在的器质性病变。
