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Case Reports
. 2012 May;82(5):325-9.
doi: 10.4174/jkss.2012.82.5.325. Epub 2012 Apr 26.

A case of giant rectal villous tumor with severe fluid-electrolyte imbalance treated by laparoscopic low anterior resection

Won Ho Choi  1 , Jongpil Ryuk, Hye Jin Kim, Soo Yeun Park, Jun Seok Park, Jong Gwang Kim, Gyu-Seog Choi
Affiliations
Case Reports

A case of giant rectal villous tumor with severe fluid-electrolyte imbalance treated by laparoscopic low anterior resection

Won Ho Choi et al. J Korean Surg Soc. 2012 May.

Abstract

McKittrick-Wheelock syndrome is a disorder caused by fluid and electrolyte hypersecretion from a colorectal tumor. To present the case of a patient with a giant rectal villous tumor with McKittrick-Wheelock syndrome who was successfully treated with laparoscopic surgery. The case of a 59-year-old man who came to the emergency department with syncope, prerenal azotemia, and electrolyte disturbances with a background of chronic diarrhea is reported. His condition was the result of fluid and electrolyte hypersecretion caused by rectal villotubular adenomas. Laparoscopic low anterior resection and subsequent volume and electrolyte replacement therapy resulted in complete recovery. A microscopic examination revealed multiple, well-differentiated adenocarcinomas arising in villotubular adenomas. Laparoscopic surgical resection is a feasible therapeutic modality for McKittrick-Wheelock syndrome.

Keywords: Diarrhea; Laparoscopy; Renal insufficiency; Villous adenoma.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
The abdominal computed tomography scan shows massive occupation by a huge villous tumor and diffuse wall thickening at the distal sigmoid colon to rectum.
Fig. 2
Fig. 2
Colonoscopy revealed multiple polypoid lesions throughout the distal sigmoid colon and rectum.
Fig. 3
Fig. 3
Macroscopic appearance of multiple polypoid lesions, measuring 25 cm × 12 cm. Most of them were villotubular adenomas. In the central ulcerative area (*), adenocarcinoma with subserosal invasion was confirmed.
Fig. 4
Fig. 4
Microscopic appearance of the well-differentiated adenocarcinoma arising in a villotubular adenoma (H&E, ×40).
See this image and copyright information in PMC

References

    1. Older J, Older P, Colker J, Brown R. Secretory villous adenomas that cause depletion syndrome. Arch Intern Med. 1999;159:879–880. - PubMed
    1. McCabe RE, Kane KK, Zintel HA, Pierson RN. Adenocarcinoma of the colon associated with severe hypokalemia: report of a case. Ann Surg. 1970;172:970–974. - PMC - PubMed
    1. Targarona EM, Hernandez PM, Balague C, Martinez C, Hernández J, Pulido D, et al. McKittrick-Wheelock syndrome treated by laparoscopy: report of 3 cases. Surg Laparosc Endosc Percutan Tech. 2008;18:536–538. - PubMed
    1. Watari J, Sakurai J, Morita T, Yamasaki T, Okugawa T, Toyoshima F, et al. A case of Cronkhite-Canada syndrome complicated by McKittrick-Wheelock syndrome associated with advanced villous adenocarcinoma. Gastrointest Endosc. 2011;73:624–626. - PubMed
    1. Miles LF, Wakeman CJ, Farmer KC. Giant villous adenoma presenting as McKittrick-Wheelock syndrome and pseudo-obstruction. Med J Aust. 2010;192:225–227. - PubMed

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