A Case of Tubulo-Villous Adenoma of the Rectum with Depletion Syndrome, Repeatedly Prolapsed and Incarcerated Through the Anus

Noriyuki Yasutomo, You Kurashima* and Satoshi Kondo*

Department of Surgery, Ishikari Hospital
Department of Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine*

A case of tubulo-villous adenoma of the rectum is reported. The patient was a 76 year-old woman who complained of general fatigue and dehydration. Electrolyte disturbances and renal dysfunction (Na 125 mEq/l, K 2.1 mEq/l, Cl 88 mg/l, BUN 57.9 U/l, CREA 1.36 mg/dl) were found, but they improved after admission. At the same time, an incarcerated tumor that had arisen from internal hemorrhoids that had repeatedly prolapsed over the past 2 years, was observed in the form of a fist-sized, soft, easy-bleeding velvet-like mass with a large quantity of mucus on its surface. A detailed examination revealed a villous tumor occupying 3/4 of the circumference of the lumen that was approximately 10 cm in diameter and 8 mm proximal to the dentate line. Super-low anterior resection was performed. The histopathological diagnosis was tubullo-villous adenoma with no malignancy and a negative cut-end. There have been no recurrences of the dehydration or electrolyte disturbances.

Key words
villous adenoma, depletion syndrome, incarceration

Reprint requests
Noriyuki Yasutomo Department of Surgery, Ishikari Hospital
3-3-13 Hanakawakita, Isikari, 061-3213 JAPAN

Accepted
February 23, 2005

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