A Case of Rectal Cancer in a 19-year-old Male with a Familial History of Cancers

Kazuhiro Sakamoto, Hiroshi Nozaki, Yasuhiro Ishii, Yasuo Hayashida, Noburu Sakakibara

First Department of Surgery, Juntendo University School of Medicine

Rectal cancer is uncommon in young adults. In people under 19 years of age, it is extremely rare. As a result, no more than about 51 cases have been reported in Japan. The present case concerns rectal cancer in a l9-year-old male with a family history of cancer. The patient consulted a physician complaining of diarrhea and hematochezia. He was subsequently admitted to our hospital because of a possible diagnosis of rectal cancer. His paternal family history revealed cancer in 11 out of 38 persons over three generations. There were 4 cases of colorectal cancer, 3 cases of gastric cancer, 2 cases of uterine cancer, one case of bladder cancer, and one case of pancreatic cancer. A barium enema showed constriction of the entire circumference of the Ra-Rs area of the rectum. A fiberscopic examination revealed a tumorous protrusion with an irregular, hemorrhagic mucosa. Biopsy revealed a poorly differentiated adenocarcinoma. The initial operation was a low anterior resection. The resected specimen was rectal cancer (diffuse type) measuring 12×8 cm. Histological examination revealed mucinous carcinoma. Thirty months after the initial operation a tumor was discovered in the patient's pelvis. CT revealed invasion of the abdominal wall and partial invasion of the wall of the bladder. Tumor resection and adjuvant chemotherapy and radiotherapy were performed. Approximately 4 years have passed since the patient's initial surgery. At present the patient is in good health and suffers no problems with respect to urination or defecation.

Key words
rectal cancer in young adults, cancer family syndrome

Reprint requests
Kazuhiro Sakamoto First Department of Surgery, Juntendo University School of Medicine
2-1-1 Hongo, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
March 11, 1992

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