Which clinical history findings are characteristic of pediatric colorectal tumors?

Updated: Jun 06, 2020
  • Author: Jaime Shalkow, MD, FACS; Chief Editor: Cameron K Tebbi, MD  more...
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Although colorectal carcinomas constitute approximately 1% of all pediatric neoplasms, they are still the most common primary gastrointestinal malignancy. Most cases of pediatric colon cancer occur during late childhood and adolescence. [18]  While the gender distribution is equal in adults, the incidence of CRC in children is higher in males, with a relative ratio of 2:1. [18, 44]  

Because of its rarity, CRC is seldom suspected in children and adolescents with abdominal symptoms. Therefore, the diagnosis is often delayed. [18]

Presenting symptoms are nonspecific and include vague abdominal pain, weight loss, nausea, vomiting, anorexia, change in bowel habits (diarrhea or constipation), abdominal mass or distension, rectal bleeding, and/or intestinal obstruction. Left-sided tumors, most common among adolescents and young adults, may cause changes in stool caliber and bowel habits, whereas right-sided tumors are more likely to cause symptoms of anemia. Rectal tumors may lead to blood per rectum and tenesmus.

Advanced stage at presentation is more likely in adolescents and young adults than in older patients. The delay from symptom onset to diagnosis of CRC in adolescents and young adults often exceeds 6 months. A low suspicion rate for malignancy and a lack of screening may contribute to the delay.

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