Advanced Mucinous Colorectal Carcinoma in a Teenager: A Case Report of a Changing Age Paradigm

Abstract

Colorectal cancer (CRC) is predominantly a disease of older adults, but its incidence among younger populations has been rising significantly. While the overall global incidence and mortality of CRC have declined due to population-based screening programs, the rate of early-onset colorectal cancer (EOCRC) in individuals under 50 has increased sharply. The reasons behind this alarming trend remain unclear. Although hereditary cancer syndromes can predispose individuals to EOCRC, the majority of these cases are sporadic, and known lifestyle risk factors such as diet, smoking, and alcohol alone do not fully explain the rise. This phenomenon is global and affects both males and females. A low clinical index of suspicion in young adults often leads to delayed diagnosis, resulting in the detection of CRC at advanced stages, which contributes to poorer outcomes, particularly in younger patients. In this case report, we describe a 19-year-old male who presented with acute abdominal distention and bloody diarrhea. Imaging revealed an obstructive colorectal tumor with extensive metastasis to the mesentery, omentum, liver, stomach, and anterior abdominal wall. An emergency colostomy was performed to relieve the obstruction, but the patient ultimately succumbed to the aggressive nature of the disease nine days later. This case underscores the importance of recognizing colorectal cancer in young patients and raises awareness of the need for early diagnosis and intervention. By increasing vigilance for EOCRC in both primary and tertiary care settings, healthcare providers can improve patient outcomes through timely referrals and treatment.