Advanced colon cancer before the age of 20 years
Hereditary nonpolyposis colorectal cancer (HNPCC) currently accounts for 2% to 6% of all colorectal adenocarcinomas. The HNPCC syndrome has classically been divided into two subgroups based on clinical presentation: Lynch I, which has no history of associated cancers, and Lynch II, which can present along with other malignancies, including cancer of the stomach, uterus, urinary tract, small bowel and bile ducts. In families with HNPCC, the mean age of diagnosis is 48 years, with some patients presenting in their twenties. Seventy per cent of the lesions are proximal to the splenic flexure.
Previous recommendations for HNPCC-affected kindreds was to begin screening family members between 20 and 30 years of age. More recently, the recommendations have been revised such that colonoscopy should occur between 20 and 25 years of age. In the present article, we report a case of colon cancer in a 19-year-old man whose diagnosis of colon cancer fulfilled the criteria for HNPCC.
A 19-year-old Japanese man presented to the emergency department with a complaint of transient self-limited left lower quadrant discomfort, a brief episode of fever and an isolated episode of passing a small amount of blood per rectum on one occasion. There was no previous history of passing blood per rectum and he was otherwise well, except for a 1.8 kg weight loss. His hematological parameters were unremarkable; specifically, his hemoglobin was 143 g/L (normal range 135 g/L to 175 g/L) with a normal mean cell volume. You will always come across discount levitra online at our place at a pharmacy that will offer best deals.