# Advanced rectal cancer in an 11-year-old Sudanese patient with rare metastatic site: a case report

## TL;DR

An 11-year-old boy with rectal cancer developed a rare skin metastasis, highlighting the challenges of diagnosing and treating pediatric colorectal cancer.

## Contribution

Reports a rare case of cutaneous metastasis in a pediatric rectal cancer patient, not previously documented in children.

## Key findings

- Pediatric CRC often presents with nonspecific symptoms, leading to delayed diagnosis.
- Cutaneous metastasis occurred in an 11-year-old with rectal adenocarcinoma after initial treatment.
- Despite treatment, the patient experienced recurrence and succumbed to the disease.

## Abstract

Colorectal cancer (CRC) is predominantly an adult malignancy, rarely affecting children, with an incidence of less than 1% in individuals under 20 years old. Pediatric CRC typically presents with nonspecific symptoms, leading to delayed diagnosis and poorer outcomes compared to adults. Cutaneous metastases in CRC are exceedingly rare, occurring in 0.7%–5% of cases, and have not been previously reported in pediatric patients. We present an 11-year-old male with rectal adenocarcinoma who developed cutaneous metastasis after initial treatment. Misdiagnosis and delayed presentation contributed to disease progression. Treatment included neoadjuvant chemoradiotherapy, surgical resection, and adjuvant chemotherapy. Despite initial symptom resolution, the patient experienced tumor recurrence with peritoneal carcinomatosis and subsequent cutaneous metastasis, ultimately succumbing to the disease. This case highlights the challenges of diagnosing and managing pediatric CRC, emphasizing the need for heightened clinical suspicion and improved access to diagnostic tools, especially in resource-limited settings.