# Early-Onset Colorectal Adenocarcinoma and Multiple Metastases in an 11-Year-Old Patient With KRAS Mutation: A Case Report

## TL;DR

A rare case of colorectal cancer in an 11-year-old with metastases and a KRAS mutation highlights unique challenges in diagnosing and treating early-onset colorectal cancer in children.

## Contribution

The case provides new insights into the molecular pathogenesis and treatment challenges of early-onset colorectal cancer in pediatric patients.

## Key findings

- The patient had colorectal adenocarcinoma with multiple metastases and a KRAS mutation.
- The disease showed aggressive progression and limited response to therapies in a pediatric patient.
- This case highlights the rarity and distinct features of early-onset colorectal cancer in children.

## Abstract

Early-onset colorectal cancer (EO-CRC), defined as colorectal adenocarcinoma diagnosed before age 50, is increasing globally, with distinct clinicopathologic and molecular features compared to adult-onset disease. While risk factors such as genetic mutations and lifestyle influences are implicated, pediatric cases remain exceptionally rare. This report presents a unique case of colorectal adenocarcinoma with multiple metastases in an 11-year-old patient, contributing critical insights into the molecular pathogenesis and diagnostic challenges of EO-CRC in pediatric populations. Furthermore, the aggressive nature of this disease underscores significant treatment challenges, ranging from limited evidence-based therapeutic protocols for young patients to variable responses to multimodal therapies, resulting in a generally poor prognosis.