Giant tubular adenoma with malignancy clinical characteristics in a female teenager

Abstract

Background:Adenomas of the colon are usually benign tumors which carry a tendency for malignancy. These tumors can be villous, tubular, tubulovillous, or sessile serrated. Those with adenomatous structure can develop malignant characteristics in 1.5% to 9.4% of cases.Methods:We present a case report of a 16-year-old female adolescent with an adenoma of the descending colon. History revealed prolonged diarrheic syndrome for the past 6 months, repeated headache, and a weight loss of ∼5 kg in the past month. One week before the admission, the patient presented an episode of inferior digestive hemorrhage.Results:On admission laboratory tests revealed iron deficiency anemia, and a mildly increased erythrocyte sedimentation rate. The abdominal ultrasound revealed an inhomogeneous mass of the descending colon and 2 hyperechoic lesions in the liver. The colonoscopy showed a tumor of the descending colon, a tubular adenoma according to the pathological examination. Additionally, we noted an atypical presentation of the tumor and the signs of mild dysplasia identified at the pathological examination.Conclusion:Weight loss, bowel transit alterations, loss of appetite, and inferior hemorrhage in an adolescent can be symptoms of a benign or malignant tumor of the colon.

Pediatric Rectosigmoid Atypical Juvenile Polyps Presenting With Rectal Prolapse and Acute Bleeding: A Case Report and a Comprehensive Literature Review

“…Nevertheless, sometimes other histological subtypes such as hamartomatous polyps or tubular adenomas are identi ed. In this last case, low degree dysplasia has been described, although not neoplasms as such [12]. The most frequent presentation is a solitary polyp, although sometimes they may occur in the context of polyposis syndromes, as in the case of juvenile polyposis syndrome (SPJ), PTEN hamartoma tumor syndrome, Peutz-Jeghers syndrome, or familial adenomatous polyposis [13,14].…”

McKittrick–Wheelock Syndrome: A Rare Case of Secretory Diarrhea

“…Tubulovillous adenomas are, as the name suggests, adenomas that carry both tubular and villous features [8]. Malignancy risk tends to increase linearly with an increase in the size of the polyp, positive family history of colon cancer, histological type, and degree of dysplasia [10,11].…”

Atypical onset of total colonic Hirschsprung disease in a small female infant

“…[ 3 ] Nevertheless, functional constipation must also be taken into account into the differential diagnosis as the most frequent cause of constipation with negative psychosocial impact. [ 21 ] Also, in rare cases constipation can be caused by celiac disease, [ 22 , 23 ] it can be associated with giant colonic polyps leading to subocclusive symptoms, [ 24 ] or with nutritional disorders, such as obesity in children. [ 25 ] Our patient also presented with constipation and failure to thrive, but she did not associate hypoproteinemia.…”