Colorectalcarcinoma is the second most common alimentary tract carcinoma after liver
tumors in children with an incidence of 1.3-2 cases per million population,
mostly present in the second decade of life. It tends to be very aggressive and
present late, due to which it has very poor prognosis. It may present itself
with distant metastasis. But metastasis to the testes is very rare and
signifies advanced stage of the disease. Surgery is the only effective modality
to cure patients with localized colorectal carcinomas. We are presenting a case
of advanced colorectal carcinoma in an adolescent with testicular metastasis.
A15 years old Indian male presented to Surgical emergency with complaints of
difficulty in passing stool for one month, passage of blood and mucus per
rectum for 15 days, abdominal distension for 1week and obstipation for 3 days.
These symptoms were associated with significant appetite and weight loss but
there was no history of fever, jaundice, malena, hemetemesis, hemoptysis,
cough, chest pain shortness of breath. There was no history of similar illness
in family, and any other malignancy.
Onexamination patient was conscious with thin built and pallor was present.
Abdomen was distended with no local bulge. On digital rectal examination, a
circumferential proliferative growth was felt 1cm above the anal verge, which
was occluding the lumen near completely. On scrotal examination, a small nodule
was felt in Right testis. Rest systemic examination was normal. An
abdominal and chest X-ray was done as preliminary investigations which revealed
signs of intestinal obstruction.
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