Advanced colon cancer before the age of 20 years: CASE PRESENTATION
A flexible sigmoidoscopy performed 20 days after his emergency department presentation was unremarkable and he had not had a second episode of rectal bleeding in the intervening time period. His previous symptoms had resolved completely. The only remarkable feature about this patient was that his mother had undergone a right hemicolectomy 12 years previously at the age of 34 years for colon cancer in Japan. She had undergone annual surveillance barium enemas in Japan but had failed to pursue further follow-up after her immigration to Canada.
The maternal grandfather had died at the age of 50 years, reportedly of metastatic colon cancer, and a maternal aunt reportedly had colonic polyps, but not cancer, at the age of 54 years. There was no family history of extraintestinal malignancy. Following the patient’s flexible sigmoidoscopy, it was recommended he undergo colonoscopy at age 25 years or sooner if rectal bleeding recurred. Three months later, the patient was investigated by his family physician for unexplained fever and a possible pelvic mass. A computerized tomography scan of the abdomen and pelvis, performed two days before his 20th birthday, revealed an 11.9 cm pelvic mass adjacent to the cecum. The patient underwent colonoscopy three days after his 20th birthday. A large polypoid mass was found in the ascending colon that, on histological examination of the biopsied tissue, was confirmed to be a moderately differentiated adenocarcinoma. Buy quality medications online: find sale cialis tablets buy here every time you need treatment.