A Case of Villous Tumor of the Rectum with Electrolyte Depletion Syndrome

Hideki Yamashita, Chusei Ryu, Yoshihiro Matsumoto, Yuji Ohta and Akira Adachi

Department of Surgery, Tagawa Municipal Hospital

A 65-year-old woman admitted for mucous diarrhea and melena was found in colonoscopy to have an encircling flat protruding tumor with a villous structure 1 cm above the dentate line and extending upward for 13 cm. We diagnosed her as having rectal villous adenoma with well-differentiated adenocarcinoma based on a pathological examination of the biopsy specimen. She had dehydration, hypokalemia (2.1 mEq/l), hyponatremia (117 mEq/l), and hypochloremia (60 mEq/l) at admission, leading to a diagnosis of electrolyte depletion syndrome (EDS), necessitating rehydration with saline containing potassium chloride. We performed abdomino-perineal resection and resection of a right ovarian cyst. The resected specimen was 15×12 cm villous adenoma with well- differentiated adenocarcinoma. The postoperative course was uneventful and EDS has been ameliorated. To our knowledge, 55 case reports have been made of villous adenoma with EDS in Japan.

Key words
villous tumor, electrolyte depletion syndrome

Reprint requests
Hideki Yamashita Department of Surgery, Tagawa Municipal Hospital
1700-2 Hoshii, Tagawa, 825-8567 JAPAN

Accepted
July 27, 2005

To read the PDF file you will need Abobe Reader installed on your computer.