Cytoreductive surgery and HIPEC in a 14 years old patient with peritoneal recurrence of adenocarcinoma of the right colon

Lorena Sorrentino; Francesco Serra; Francesca Cabry; Stefano De Julis; Elisa Barbieri; Massimo Girardis; Pier Luca Ceccarelli; Roberta Gelmini

doi:10.1016/j.ijscr.2019.02.046

Cytoreductive surgery and HIPEC in a 14 years old patient with peritoneal recurrence of adenocarcinoma of the right colon

Int J Surg Case Rep. 2019:57:118-121. doi: 10.1016/j.ijscr.2019.02.046. Epub 2019 Mar 21.

Authors

Lorena Sorrentino¹, Francesco Serra², Francesca Cabry³, Stefano De Julis⁴, Elisa Barbieri⁵, Massimo Girardis⁶, Pier Luca Ceccarelli⁷, Roberta Gelmini⁸

Affiliations

¹ Department of Surgery, University of Modena and Reggio Emilia - Policlinico of Modena, Via del Pozzo, 71, 41100 Modena, Italy. Electronic address: lorena.sorrentino@live.it.
² Department of Surgery, University of Modena and Reggio Emilia - Policlinico of Modena, Via del Pozzo, 71, 41100 Modena, Italy. Electronic address: serrafrancescomd@gmail.com.
³ Department of Surgery, University of Modena and Reggio Emilia - Policlinico of Modena, Via del Pozzo, 71, 41100 Modena, Italy. Electronic address: francesca.cabry@unimore.it.
⁴ Department of Anesthesiology, University of Modena and Reggio Emilia - Policlinico of Modena, Via del Pozzo, 71, 41100 Modena, Italy. Electronic address: dejulis@hotmail.com.
⁵ Department of Anesthesiology, University of Modena and Reggio Emilia - Policlinico of Modena, Via del Pozzo, 71, 41100 Modena, Italy. Electronic address: elisabarbieri.bb@gmail.com.
⁶ Department of Anesthesiology, University of Modena and Reggio Emilia - Policlinico of Modena, Via del Pozzo, 71, 41100 Modena, Italy. Electronic address: massimo.girardis@unimore.it.
⁷ Department of Anesthesiology, University of Modena and Reggio Emilia - Policlinico of Modena, Via del Pozzo, 71, 41100 Modena, Italy. Electronic address: ceccarelli.pierluca@unimore.it.
⁸ Department of Surgery, University of Modena and Reggio Emilia - Policlinico of Modena, Via del Pozzo, 71, 41100 Modena, Italy. Electronic address: roberta.gelmini@unimore.it.

Abstract

Introduction: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is nowadays a feasible and effective treatment for peritoneal metastasis. We present a case of a 14 years old child with peritoneal metastasis from recurrent colorectal cancer.

Presentation of case: Colonoscopy and CT-scan were performed leading to the diagnosis of a stenosing adenocarcinoma of the right colon in 2015. Two pelvic lesions were found at the total body PET scan, suspected for peritoneal metastasis. Neoadjuvant chemotherapy was administered, and restaging CT-scan and magnetic resonance (MRI) highlighted a partial response. The patient underwent right laparoscopic hemicolectomy. The postoperative staging was T4 N1 G3. Seven months after the last cycle of adjuvant chemotherapy, CT-scan revealed two huge abdominal masses. The patient underwent explorative laparotomy and bilateral oophorectomy, positive for metastasis from colorectal cancer and peritoneal washing cytology was positive for neoplastic cells. A CT-scan was performed on December 2017 showed a suspect lesion below the anterior abdominal wall. The case was discussed at the tumour board and the indication for CRS and HIPEC was given. In January 2018 the child underwent complete CRS and HIPEC with no complications. No adjuvant chemotherapy was administered. After 11 months the follow up is negative for the recurrent disease.

Discussion and conclusion: Cytoreduction and HIPEC can be performed even in children as a feasible and safe treatment with successful outcomes. As for adults, an appropriate multidisciplinary pre-operative work up and a correct cases selection is needed to have the best results even regarding the quality of life.

Keywords: Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy (HIPEC); Oncological surgery; Pediatric surgery; Peritoneal surface malignancies.