Frestad Daria, Perner Anders, Pedersen Ulf Gøttrup
Department of Cardiology, Hvidovre Hospital, Copenhagen, Denmark.
Department of Intensive Care, Rigshospitalet, Copenhagen, Denmark.
BMJ Case Rep. 2014 Sep 24;2014:bcr2014205002. doi: 10.1136/bcr-2014-205002.
Colourectal cancer (CRC) is the fourth most common cause of death from cancer worldwide. While rates for CRC in adults age 50 and older have been declining, incidence rates in young adults, a population routinely not screened, has been increasing. We report a rare case of high-grade CRC in a previously healthy 27-year-old man, presented to us with symptoms of increasing abdominal pain and distension. Extensive diagnostic investigation revealed hepatomegaly with multiple processes, signs of vasculitis, extensive liver necrosis, enlarged retroperitoneal and mesenteric lymph nodes, splenomegaly, ascites and multiple vein thrombosis. The patient passed away shortly after admission due to treatment-resistant tumour lysis syndrome and multiple organ failure. Biopsy results revealed disseminated adenocarcinoma of the colon, with metastases to lymph nodes, liver, lungs and pleura. CRC in younger patients tend to present at a later stage and appears to be more aggressive, with a poorer pathological differentiation.
结直肠癌（CRC）是全球第四大常见癌症死因。虽然50岁及以上成年人的结直肠癌发病率一直在下降，但在通常未接受筛查的年轻成年人中，发病率却在上升。我们报告了一例罕见的高级别结直肠癌病例，患者为一名27岁的既往健康男性，因腹痛和腹胀加重前来就诊。广泛的诊断性检查发现肝脏肿大并伴有多个病变、血管炎体征、广泛的肝坏死、腹膜后和肠系膜淋巴结肿大、脾肿大、腹水以及多处静脉血栓形成。患者入院后不久因难治性肿瘤溶解综合征和多器官衰竭去世。活检结果显示为结肠弥漫性腺癌，已转移至淋巴结、肝脏、肺和胸膜。年轻患者的结直肠癌往往在较晚阶段出现，且似乎更具侵袭性，病理分化较差。
