eP122 - Rising to Innovation: The First Case Report of Early-Onset Colon Cancer in the Dominican Republic Managed by Robotic Right Hemicolectomy

Purpose/Background: Colorectal cancer (CRC) is the most common GI malignancy, occupying the third place in frequency worldwide. There is an uptrend in cases in the population before the age of 50, denominated early onset colon cancer. In the United States, about 35% of colon cancer in the young population can be accredited to known hereditary symptoms. However, little is known about sporadic CRC in this population. It is suspected that the frequency of this condition is prevalent in developing countries. No reports have been published in the Dominican Republic, and the need for proper workup and documentation is needed. Here we present the first case report of sporadic early onset colon cancer, which is coincidentally the first Robotic Right Hemicolectomy ever performed in the country.Methods/Interventions: First case report of early onset colon cancer and the first report of Robotic Right hemicolectomy in the Dominican Republic.Results/Outcomes: A 34-year-old male patient came with a chief complaint of abdominal pain and a change in bowel habits for 6 months. Medical history was relevant for obesity, occasional cigarette smoking, and social alcohol consumption. He denied a family history of malignancy. After initial primary evaluation, he was referred to gastroenterology for a colonoscopy which was significant for a nearly obstructing ascending colon mass. Biopsy was significant for mucinous adenocarcinoma.
He was seen by the Surgery team and scheduled for a Robotic Right Hemicolectomy. He underwent the procedure without perioperative complications. Pathology results showed: infiltrating mucinous adenocarcinoma with signet ring cells invading peri-colonic fat. 14 lymph nodes were retrieved, with 3 positive lymph nodes. The final stage was T3N1M0. The genetic panel was only positive for TP53 mutation, all else was negative. The patient had a chemotherapy port placement, was discharged home, and is currently undergoing adjuvant therapy. Further patient history showed no other cancer incidence among other family members. Both parents are alive and healthy and both son and daughter are alive and healthy, with no other relatives with alleged cancer history.Conclusion/

Discussion: This case represents a milestone in the Dominican Republic, representing the first documented case of sporadic early-onset colon cancer and the first case of Robotic Colectomy. Colorectal cancer (CRC) is a global concern, ranking third among gastrointestinal malignancies. However, there is growing concern about an increase in cases of early-onset colon cancer in people under 50 years of age. In the United States, approximately 10-30% of cases are linked to genetic factors, but our understanding of sporadic CRC remains limited, especially in developing countries.
This case report highlights the need to recognize and document the early onset of colon cancer in the Dominican Republic, where there have been no previous publications on the disease.
The patient, a 34-year-old man with no family history of malignancy, presented with symptoms typical of colon cancer, and genetic testing revealed a TP53 mutation, raising questions about genetic factors in the early stages of colon cancer.
This case report contributes to the understanding of sporadic early-onset colon cancer in the Dominican Republic and highlights the value of innovative surgical techniques. Early detection, intervention, and appropriate treatment will continue to be essential to improve outcomes for patients with early-onset colon cancer.En-Bloc Right Hemicolectomy specimen.