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

Abstract

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 125mEq/l, K2.1mEq/l, Cl 88mg/l, BUN 57.9U/l, CREA 1.36mg/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 10cm in diameter and 8mm proximal to the dentate line. Superlow 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.