Villous tumors of the rectum

Pheils, Murray T.

doi:10.1007/bf02586910

Cited by 26 publications

(9 citation statements)

References 3 publications

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“…One series of 18 patients described tumours ranging between 7 cm and 18 cm 3 . Roughly 2% of patients with rectosigmoid villous adenoma will develop hypersecretory complications 4 …”

Section: Discussionmentioning

confidence: 99%

Giant villous adenoma presenting as McKittrick–Wheelock syndrome and pseudo‐obstruction

Miles

Wakeman

Farmer

2010

Medical Journal of Australia

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“…One series of 18 patients described tumours ranging between 7 cm and 18 cm 3 . Roughly 2% of patients with rectosigmoid villous adenoma will develop hypersecretory complications 4 …”

Section: Discussionmentioning

confidence: 99%

Giant villous adenoma presenting as McKittrick–Wheelock syndrome and pseudo‐obstruction

Miles

Wakeman

Farmer

2010

Medical Journal of Australia

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“…In the case presented here, the lesion was 10-12 cm long and completely circumferential. Approximately 2% of patients with rectosigmoidal villous adenoma develop hypersecretory complications [3]. Fluid reabsorption was likely inhibited in the patient in the present case due to the limited remaining amount of normal colonic mucosa as a result of the distal villous adenoma [4].…”

Section: Discussionmentioning

confidence: 63%

Mckittrick-Wheelock Syndrome: A Case Report

Čerņevskis¹,

Staka²,

Puķītis³

et al. 2016

Arc Cas Rep CMed

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“…2 This hypersecretory function is reported to occur in 2%-3% of large villous adenomas, typically greater than 3-4 cm in diameter and located in the rectosigmoid colon where the surface area for normal reabsorption is limited. [3][4][5] Rarely, as seen in our patient's case, intussusception and rectal prolapse can occur owing to the large size and distal location of the adenoma. 6 The hydroelectric derangements associated with hypersecretory villous adenomas can be striking.…”

Section: Discussionmentioning

confidence: 99%

McKittrick–Wheelock syndrome

Raphael

McDonald

Detsky

2015

CMAJ

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A 58-year-old woman presented to the emergency department. She had been vomiting and feeling confused for three days, and she had fallen several times.Three months before her presentation, the patient had been admitted to the intensive care unit at another hospital for profound dehydration, acute kidney injury (creatinine 690 [normal 61.9-115] μmol/L) and a serum sodium level that the laboratory had reported as "undetectable." Under the direction of a nephrologist, the patient's metabolic abnormalities were corrected to near-normal values with intravenous administration of fluids.The patient's medical history included rectal prolapse of two years' duration and a worsening, clear rectal discharge of four years' duration. The discharge had become so profuse that she required wearing adult briefs 24 hours each day. She had previously undergone evaluation by a general surgeon and urogynecologist. A flexible sigmoidoscopy performed one year before her current presentation was of limited quality owing to stool and liquid in the rectum but was reported as "grossly normal to 10 cm."On physical examination, the patient was alert and oriented, but her verbal responses were delayed. She had a laceration and ecchymosis over the forehead. Her vital signs were as follows: blood pressure 97/54 mm Hg, heart rate 70 beats/min, respiratory rate 18 breaths/min, oxygen saturation 97% on room air, body temperature 36.3°C), and her jugular venous pulse was not visible above the clavicle. Cardiovascular, respiratory and neurologic examinations werenormal. An examination of the patient's perianal region showed copious leakage of a clear, colourless fluid, but no other abnormalities were identified. On digital examination, however, a soft, fleshy mass 4-5 cm in diameter was palpated.Laboratory investigations identified hyponatremia ( The patient's serum sodium was slowly corrected over the next 60 hours (Appendix 1, available at www.cmaj.ca/lookup/suppl/doi:10.1503/ cmaj .141195 /-/DC1). We performed a flexible sigmoidoscopy, which identified a massive rectal lesion at 5 cm that could not be bypassed with the colonoscope (Figure 1). Multiple biopsy samples were taken, and pathology identified a tubulovillous adenoma with no evidence of highgrade dysplasia. A computed tomography scan of the abdomen and pelvis showed a large frondlike rectosigmoid tumour, with transient intussusception into the lower rectum and no clear radiographic evidence of extramural invasion (Figure 2). The patient was taken to the operating room where an open, low-anterior resection with coloanal anastomosis and a defunctioning loop ileostomy was performed. Surgical pathology identified a 10.7-cm obstructing tumour located below the peritoneal reflection. Most of the tumour comprised tubulovillous adenoma, but multiple foci of high-grade dysplasia and a single focus of invasion into the submucosa were seen. One of 27 lymph nodes resected with the specimen was positive for adenocarcinoma. Therefore, the final pathologic diagnosis was rectal adenocarcinoma.

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Villous tumors of the rectum

Cited by 26 publications

References 3 publications

Giant villous adenoma presenting as McKittrick–Wheelock syndrome and pseudo‐obstruction

Giant villous adenoma presenting as McKittrick–Wheelock syndrome and pseudo‐obstruction

Mckittrick-Wheelock Syndrome: A Case Report

McKittrick–Wheelock syndrome

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