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Case Reports
. 2022 Jun;38(3):266-270.
doi: 10.3393/ac.2020.00745.0106. Epub 2021 Jul 13.

McKittrick-Wheelock Syndrome: A Case Series

Maureen Elvira P Villanueva  1 , Mark Augustine S Onglao  1 , Mayou Martin T Tampo  1 , Marc Paul J Lopez  1
Affiliations
Case Reports

McKittrick-Wheelock Syndrome: A Case Series

Maureen Elvira P Villanueva et al. Ann Coloproctol. 2022 Jun.

Abstract

McKittrick-Wheelock syndrome is a rare and life-threatening disease characterized by the triad of (1) chronic mucous diarrhea, (2) renal function impairment with hydroelectrolyte imbalance, and (3) a giant colorectal tumor. Often, the tumor is a rectal adenoma. With the mortality being certain, if left untreated, it is important to raise awareness on the presentation, diagnosis, and management of this disease entity. Here, we presented 3 cases of McKittrick-Wheelock syndrome that were successfully managed with surgical resection at the Philippine General Hospital from August 2018 to May 2019. Resolution of their symptoms, reversal of their renal impairment, and correction of their electrolyte depletion were noted after removal of the tumor with a sphincter-saving operation.

Keywords: Colorectal neoplasms; McKittrick-Wheelock syndrome.

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Conflict of interest statement

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

Figures

Fig. 1.
Fig. 1.
(A–C) Colonoscopic images. (A) Polypoid lesion with friable mucosa. (B) The same lesion seen with respect to the inferior rectal valve. (C) Proximal extent of the adenoma with multiple villous projections on the mucosal surface and copious mucinous secretions. (D, E) Gross specimen. (D) Rectal segment with adenomatous polyps 3 cm up to 10 cm from anal verge. (E) Cross section, macroscopic view of villous projections. (F) Microscopic sections show glands composed of tubular and villous components lined by cells with enlarged, hyperbasophilic, and stratified nuclei (H&E stain, ×100). Philippine General Hospital, 2018.
Fig. 2.
Fig. 2.
(A) Large rectal mass with copious mucin, seen prolapsing from the anal verge in a 62-year-old female patient. (B) Photomicrograph showing well-formed tubules and glands, infiltrating into fibers of the muscularis propria (H&E stain, ×100). Philippine General Hospital, 2019.
Fig. 3.
Fig. 3.
(A) A rectal mass prolapsing from the anal verge with mucinous discharge. (B) Postoperative site after abdominotransanal resection and coloanal anastomosis. (C) Glandular proliferation showing high grade nuclei extending no deeper than the muscularis mucosa (H&E stain, ×100). Philippine General Hospital, 2019.
See this image and copyright information in PMC

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