From the Guidelines
Adenocarcinoma in a 13-month-old child is extremely rare and requires immediate referral to a pediatric oncologist at a specialized children's hospital with expertise in pediatric cancers. The treatment approach will depend on the specific location of the adenocarcinoma, its stage, and genetic profile, but typically involves a multimodal approach including surgery, chemotherapy, and possibly radiation therapy 1.
Key Considerations
- The surgical team will aim to completely remove the tumor if possible, followed by chemotherapy regimens specifically tailored for infants, using reduced doses to minimize long-term side effects while maintaining efficacy.
- Common chemotherapy agents might include cisplatin, doxorubicin, or cyclophosphamide, but the exact protocol will be determined by the oncology team.
- Parents should be prepared for frequent hospital visits, potential hospitalization periods, and close monitoring for treatment side effects.
- Supportive care including nutritional support, pain management, and developmental services is crucial during treatment.
Importance of Specialized Care
The prognosis varies widely depending on cancer type, location, and stage, but pediatric cancers often respond better to treatment than adult cancers 1. Genetic testing of the tumor is important as it may reveal targetable mutations or hereditary cancer syndromes that could affect treatment decisions and family counseling. A multidisciplinary team with pediatric expertise, including a pathologist experienced in pediatric oncology, is essential for accurate diagnosis and effective treatment 1.
Recommendations
- Referral to a pediatric cancer center for prompt and accurate diagnosis and management is recommended 1.
- Treatment should be coordinated by a board-certified pediatric hematologist/oncologist, and may be continued at a center not specialized in pediatric oncology under the oversight of the pediatric cancer center's multidisciplinary team 1.
From the Research
Adenocarcinoma in Children
- Adenocarcinoma is a rare type of cancer in children, and its diagnosis and treatment can be challenging 2, 3, 4, 5, 6.
- The presentation of adenocarcinoma in children can vary depending on the location of the tumor, but common symptoms include abdominal distension, constipation, and bleeding per rectum 4, 6.
- Diagnostic confirmation and primary treatment of adenocarcinoma in children should be centralized in reference centers, collaborative networks, or both, with multidisciplinary approaches and very specific expertise 2.
Specific Cases of Adenocarcinoma in Children
- A 10-year-old girl presented with brain metastases due to primary pulmonary adenocarcinoma, and was treated aggressively with chemotherapy, surgery, and radiation therapy 2.
- A 9-year-old boy was diagnosed with pancreatic ductal adenocarcinoma, and was treated per the National Comprehensive Cancer Network guidelines for adults with pancreatic cancer 3.
- Three cases of adenocarcinoma of the colon in children, including a 13-year-old boy and a 13-year-old girl, were reported, highlighting the importance of suspecting colon cancer in children with unexplained persistent constipation, abdominal distension, or bleeding per rectum 4.
- A case of gastric adenocarcinoma in an 8-year-old girl was reported, discussing the presentation, current management guidelines, and prognosis of this rare pediatric entity 5.
- A 17-year-old male adolescent with colon adenocarcinoma presented with recurrent epigastric colic pain, and diagnostic laparoscopic surgery revealed a tumor at the ascending colon with serosal involvement and peritoneal metastasis 6.
Treatment and Prognosis
- Treatment of adenocarcinoma in children often involves a combination of chemotherapy, surgery, and radiation therapy 2, 3, 5.
- The prognosis for children with adenocarcinoma is generally poor, but can vary depending on the location and stage of the tumor, as well as the effectiveness of treatment 2, 3, 4, 5, 6.